Review Article of Multifaceted Intervention on Diabetes Mellitus

 

Lingaraju CM1, Golda Sahaya Rani2, Lissa J3

1Asst. Professor, JSS College of Nursing, Mysuru, Research Scholar,

Sri Sathya Sai Medical College and Research Institute, Sri Balaji Vidhyapeeta, Pondicharry.

2Professor, Sri Sathya Sai College of Nursing,

Sri Sathya Sai Medical College and Research Institute, Chengalpet Dist, Tamilu Nadu.

3Professor, JSS College of Nursing, JSS Academy of Higher Education and Research JSSAHER, Mysore, Mysore Dist, Karnataka.

*Corresponding Author E-mail: lingarajucm2012@gmail.com

 

ABSTRACT:

Diabetes mellitus is one of the commonest problem all the part of the world, according to International diabetes federation type II Diabetes mellitus incidental rate is increased in India. uncontrolled diabetes may have several complication on all the vital organs in the body. diabetes management is mandatory for the patients to have quality of life. hence in this context multifaceted intervention have a major impact to have optimum glycemic control in such patients. The purpose of this study to assess the effectiveness of multifaceted intervention among type II Diabetes mellitus patients. The key words of the study is diabetes mellitus, multifaceted intervention, one to one counseling, diabetes self management. Multifaceted intervention and type II Diabetes mellitus were used to search for articles in Google scholar, pub med, proquest, science direct, helinet, etc. following the only few article chosen based on the inclusion criteria mentioned in the article. Finally I concluded that multifaceted intervention will have positive impact on type II Diabetes patients for glycemic control.

 

KEYWORDS: Diabetes mellitus, Multifaceted intervention, Type II Diabetes mellitus patients.

 

 

 

INTRODUCTION:

Diabetes mellitus is one of he most common endocrine diseases affects all the parts of the world. According to WHO, About 422 million people worldwide have diabetes, the majority living in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades.1 

 

According to WHO, In India, there are estimated 77 million people above the age of 18 years are suffering from diabetes (type 2) and nearly 25 million are pre diabetics (at a higher risk of developing diabetes in near future). More than 50% of people are unaware of their diabetic status which leads to health complications if not detected and treated early. Adults with diabetes have a two-to three-fold increased risk of heart attacks and strokes. Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection, and the eventual need for limb amputation. Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. Diabetes is among the leading causes of kidney failure.2

 

The 10th edition of the IDF Diabetes Atlas reports a continued global increase in diabetes prevalence, confirming diabetes as a significant global challenge to the health and well-being of individuals, families and societies In India, there are estimated 77 million people above the age of 18 years are suffering from diabetes (type 2) and nearly 25 million are prediabetics (at a higher risk of developing diabetes in near future). More than 50% of people are unaware of their diabetic status which leads to health complications if not detected and treated early. Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes. Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection, and the eventual need for limb amputation. Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. Diabetes is among the leading causes of kidney failure.3

 

METHODOLOGY:

In the month of June 2024, article were collected and reviewed.the articles are accesses via using ket words such as diabetis mellitus, multifaceted intervention, control of blood glucose level, glycemic control, quality of life from several electronic data bases, including Google scholar, helinet, pubmed, proquist, Baidu Scholar, CNKI, Wan fang Data, science direct, finally I selected only relevant article based ot the inclusion criteria In this article majority of the Authors are used quasi experimental, true experimental, randomized control trials (RCT) WERE used as a research design, later data was extracted grouped and summarized 187 article were obtained via selection process based on the. these article were analyzed, critiqued finally 18 article were found to be relevant.

 

RESULT AND DISCUSSION:

The review of literature focuses on the effectiveness of multifaceted intervention on type II diabetes mellitus. this has the major impact on glycemic control. the articles reviewed strongly supports that multifaceted intervention is beneficial for type II Diabets mellitus patients.

 

Inclusion Criteria:

1.     Research related to multifaceted intervention on diabetes mellitus.

2.     Research reflects the results on glycemic control among diabetes mellitus.

3.     Research which is correlated research methodology

4.     text is correlating my assumptions and hypothesis

5.     The full text available in research

 

Exclusion Criteria:

1.     Unpublished research materials or articles.

2.     Publication in the form of news, quotes, abstracts and editorials.

3.     Research does not contain all the components related to research methodology.

4.     text which is not correlating my assumptions and hypothesis

5.     text not in English

 

The multifaceted intervention on type II diabetes mellitus patients results in better glycemic control, import knowledge, and adherence to the components mentioned in the multifaceted intervention such as diet, exercise glucose monitoring and ects. several studies of multifaceted intervention related type II Diabetes mellitus have found that it will maintains not only glucose level but also improves quality of life, reduction in stress, behavioral changes for glycemic control and drastically reduces the ill habits such as smoking, consuming alcohol, chewing tobacco etc. helps to control favorable behavior for glycemic control. Hence it has the positive impact on patients who is having type to Diabetes mellitus.

 

Overall, addressing the challenges in diabetes care requires a multi-faceted approach involving increased awareness, improved diagnosis and access to care, affordability, enhanced there knowledge and practice and developing positive attitude to maintain glucose level. Stress management such as effective implementation of this multifaceted intervention will have positive impact on type II Diabetes mellitus. many studies conducted all the parts of the world will revealed the same results. diabetes mellitus especially type II diabete l can be maintain by quality of life, stress reducing technique etc. study conducted in India also explained the same result to maintain the glycemic control. so multifaceted intervention have major role to maintaine normal glucose level.

 

According to article published in the journal recently also stressed the importance of multifaceted intervention the data collected in the grass root level brings experimental evidence to the effectiveness of a multifaceted intervention through field-level health workers which to improve and maintain glycemic control among diabetic patients in the primary care settings. The study has shown that a well-designed health worker intervention can translate to attitude change and skill development which in turn can reflect in the improvement of glycemic control among the patients. The study emphases the need to intervention in the health sector to address the problem and to manage effectively .The study also attempted to elucidate the mechanism by which the intervention improved glycemic control of which improvement in multifaceted intervention follow-up, physical activity, fruit and vegetable intake by the participants were found to be the major contributors and demonstrating the role of diet and physical activity, the achievement of adequacy in these regards it has a vital role on type II Diaabetis mellitus patients. As per Indian Council of Medical Research – India Diabetes (ICMR INDIAB) study published in 2023, the prevalence of diabetes is 10.1 crores.4

 

The systematic review article published at one of the reputed journal diabetic care revealed that, Achieving a high degree of responsiveness to individual needs and making extensive use of behavioral methods requires one-on-one attention by highly trained personnel, again, with significant resource implications. If those personnel are community members, additional time and effort is required for their training on multifaceted intervention supervision, and support. Finally, successful interventions may require multiple contacts over a prolonged period of time such as diet therapy, brisk walking exercise, pranayama, quitting of smoking and alcoholism and chewing tobacco have high degree of responses to maintain glucose level.

 

The patients who are benefitted from multifaceted intervention they will have better knowledge, favorable attitude, self efficacy, positive behavior to maintain the normal glucose level. they will also understand there pathological condition and learn to maintain glycemic control. it can be a diet, exercise, frequently monitoring blood glucose level, regular follow up and avoiding smoking, alcoholism. Awareness of the problem and counseling itself helps a lot to reduce the fear. Anxiety it helps to create positive nature to manage their disease. Improve the quality of life by reducing the stress. Hence the effectiveness of multifaceted intervention favorably improves the condition of the patients to have glycemic control.

 

Figure 01: Schematic Representation of Data Screening

Source: Created by own


 

Table No: 1 Article review

Sl. No

Title

Journal

Purpose

Research design

Sample size

Conclusion

01.

Effects of a multifaceted nurse-coaching intervention on diabetic complications and satisfaction in persons with type 2 diabetes.

Chulalongkorn University Intellectual Repository

CUIR Journal5

available at

cuir.car.chula.ac.th

Examine the effects of multifaceted nurse-coaching intervention on diabetic complications and satisfaction in persons with type 2 diabetes.

research quasi-experimental 

40

Persons with type 2 diabetes who received the multifaceted nurse-coaching intervention had higher satisfaction scores than persons who did not receive the intervention at the 12 th week

02

Type-2 diabetes patients’ glycemic control and quality of life as outcomes of family- integrated diabetes education in two tertiary hospitals in southwestern nigeria

Journals of UI Post graduate college

Date: 2020-026

Available at

http://140.105.46.132:8080/xmlui/handle

 

Diabetes Self-Management Education (DSME) is germane to achieving optimum glycemic control and Quality of Life (QoL).

Pre experimental research design

60

Diabetes Self-Management Education (DSME)is achieving optimum glycemic control and improves quality of life.

03

Improvements in patient-reported outcomes associated with an intervention to enhance quality of care for rural patients with type 2 diabetes: results of a controlled trial 

Journal of Diabetic care

Volume 27,

Issue 6

1st June 20047

 

available at

https://diabetesjournals.org/care/article/27/6/1306/22681/Improvements-in-Patient-Reported-Outcomes

To examine patient-reported outcomes in a controlled trial of a multifaceted provider-level intervention to improve quality of care for rural patients with type 2 diabetes.

Controlled trials

372

A provider-level intervention directed at improving quality of clinical care for patients with type 2 diabetes also had a favorable impact on overall health-related quality of life, satisfaction with care, and other humanistic outcomes.

04

Examining the diabetes distress, medication adherence, diabetes self-care activities, diabetes-specific quality of life and health-related quality of life among type 2 diabetes mellitus patients.

Journal of Clinical & Translational Endocrinology

Volume 9, September 2017, Pages 48-58

available at

https://pubmed.ncbi.nlm.nih.gov/29067270/

assess the diabetes distress, medication adherence, diabetes self-care activities, diabetes-specific quality of life and health-related quality of life among type 2 diabetes mellitus patients

cross-sectional study design

497

The various health outcome indicators such as DM distress, adherence and diabetesdependent QOL need to be considered in clinical practice for maintain the blood glucose level in those patients

05

Controlled Trial of a Multifaceted Intervention for Improving Quality of Care for Rural Patients With Type 2 Diabetes

American diabetic association

Volume 26,

Issue 11

1ST November 20039

available at

https://pubmed.ncbi.nlm.nih.gov/14578240

Assess the effectiveness of multidisciplinary diabetes outreach service

(intervention) for improving the quality of care for rural patients with type Type II diabetes.

Randomized Controlled Trial

Simple random sampling

Size 67

A diabetes outreach service has the potential to improve the quality of diabetes care for rural patients

06

A multifaceted intervention in support of diabetes treatment guidelines: a cont trial

Diabetes Research and Clinical Practice

Volume 58.

Issue 01

October 2002

pages 27-3610

multifaceted intervention care managing diabetes

Controlled trials

Random sampling technique

Size 80

multifaceted intervention care managing diabetes maintained

normal glycemic level.

 

07

Outcomes of a Multifaceted Physical Activity Regimen as Part of a Diabetes Self-Management TYPE II Diabetes mellitus.

Annals of behavioral medicine

 

Volume 31

Issue 2

April available at 2006https://www.clinicalkey.com.

The goals of this research were to evaluate the effectiveness of a multifaceted intervention for people with type 2 diabetes

Controlled trials

335

. The results suggest that individuals are capable of adjusting their activity patterns improve glycemic control.

 

Improvement noted after a multifaceted approach to diabetes mellitus management

Journal of Endocrinology, Metabolism and Diabetes of South Africa.

Vol. 21 No. 1 (2016)11

available at

https://www.tandfonline.com/doi/full/10.1080/16089677.2015.1129

To assess the prognosis after a multifaceted approach to diabetes mellitus management.

True experimental,

30

Improvement noted after a multifaceted approach to diabetes mellitumanagement

08

Effect of a community-based intervention on self-care among diabetes patients in rural Tamil Nadu: A mixed-method study

Primary Care Diabetes Volume 16, Issue 4, August 2022, Pages 484-49012

Available at https://pubmed.ncbi.nlm.nih.go

To assess the Effect of a community-basedintervention on self-care among diabetes patients in rural Tamil Nadu

Mixed-Method study

168

We found an improvement in treatment adherence, self-care among DM patients’ and marginal improvement in depression status through support groupintervention

09

Effectiveness of a Non-pharmacological Intervention to Control Diabetes Mellitus in a Primary Care Setting in Kerala: A Cluster-Randomized Controlled Trial

Public Health, 16 November 2021

Volume 9 – 202113

available at

https://www.ncbi.nlm.nih.gov/pmc/

Effectiveness of a Non-pharmacological Intervention to Control Diabetes Mellitus.

Randomized control trials

98

Multifaceted health worker interventions including non-traditional training methods and attitude building can help tackle the growing burden of DM s in low income countries.

 

CONFLICT OF INTEREST:

Nill.

 

CONCLUSION:

These are the above articles were reviewed, this articles conducted in all the parts of the world, to conclude that multifaceted diabetic intervention definitely have positive impact on glycemic control, these behavior changes the lifestyle of the type II Diabetes mellitus patients. diet modification, physical activities such as brisk walking, meditation, frequent follow up, regular monitoring of glucose level These multifaceted interventions improves the physical conditions of the patients. clinical symptoms drastically comes down and biological variables such as glucose level (FBS, PBBS, RBS) comes to normal level, and especially one to one counseling will have significant role to treat and manage the type II Diabetic mellitus patients.

 

REFERENCES:

1.      https://www.who.int/health-topics/diabetes

2.      https://diabetesatlas.org/resources/

3.      https://www.who.int/india/health-topics/mobile-technology-for-preventing-ncds

4.      https://pib.gov.in/PressReleasePage.aspx

6.      cuir.car.chula.ac.th

7.      http://140.105.46.132:8080/xmlui/handle

8.      diabetesjournals.org

9.      https://pubmed.ncbi.nlm.nih.gov

10.   https://pubmed.ncbi.nlm.nih.gov/14578240/

11.   https://www.clinicalkey.com

12.   https://www.tandfonline.com/doi/full/10.1080/16089677.2015.1129704

13.   https://pubmed.ncbi.nlm.nih.gov/35606314/

14.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636158/

 

 

 

 

Received on 22.08.2024         Revised on 21.09.2024

Accepted on 11.10.2024         Published on 20.11.2024

Available online on December 28, 2024

Int. J. of Advances in Nursing Management. 2024;12(4):211-215.

DOI: 10.52711/2454-2652.2024.00047

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