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Recognition of symptoms, mitigating mechanisms and self-care experiences of type 2 diabetes patients receiving insulin treatment in North-East Ethiopia 埃塞俄比亚东北部接受胰岛素治疗的2型糖尿病患者的症状识别、缓解机制和自我护理经验
Pub Date : 2021-07-28 DOI: 10.35241/emeraldopenres.14312.1
Ewunetie Mekashaw, B. Demeke, M. Haile
Background: Compliance of patients with self-care practices is the mainstay of measures to manage diabetes. This study explored self-care practices of type 2 diabetes patients receiving insulin treatment in North-East Ethiopia. Methods: The study employed an interpretive phenomenological approach using purposive sampling. The data were collected from 24 (11 males and 13 females) participants (July 2019 to January 2020) using in-depth interviews till theoretical saturation. The data were analyzed thematically and organized using QDA Miner Lite v2.0.8. Results: The findings were categorized into: labeling diabetes, self-care maintenance experiences, recognition of symptoms, and mitigating mechanisms of symptoms. The self-care maintenance practice of patients was linked with diet input preferences and the effectiveness level of insulin. What guides the self-care behavior was the patients’ preferentiality of strictly adhering to their preferred dietary inputs. Barley and wheat were the most common preferential and non-preferential inputs, respectively. The patients strictly adhered to insulin treatment because they found it effective. The most common hyperglycemia symptoms to be managed by taking an additional dose of insulin, were frequent urination, increased thirst, and their consequences (dehydration). Excessive sweating (initial), shivering (middle), and falling (final), respectively in severity, were the most common symptoms of hypoglycemia which were perceived to be treated with sweet snacks. Originality: To our knowledge, this is the first research in Ethiopia to investigate the self-care experiences of type 2 diabetes patients receiving insulin using an interpretive phenomenological approach.
背景:患者对自我护理实践的依从性是管理糖尿病的主要措施。本研究探讨了埃塞俄比亚东北部接受胰岛素治疗的2型糖尿病患者的自我护理实践。方法:本研究采用解释性现象学方法,使用目的性抽样。数据收集自24名参与者(11名男性和13名女性)(2019年7月至2020年1月),使用深度访谈直到理论饱和。使用QDA Miner Lite v2.0.8对数据进行主题分析和组织。结果:研究结果分为:糖尿病标签、自我护理维持经验、症状识别和症状缓解机制。患者的自我护理维持实践与饮食输入偏好和胰岛素的有效性水平有关。指导自我护理行为的是患者严格遵守其偏好的饮食输入的偏好。大麦和小麦分别是最常见的优惠和非优惠投入。患者严格坚持胰岛素治疗,因为他们发现它有效。通过服用额外剂量的胰岛素来治疗最常见的高血糖症状是尿频、口渴加剧及其后果(脱水)。严重程度分别为出汗过多(最初)、颤抖(中间)和跌倒(最终),是低血糖症最常见的症状,可以用甜食治疗。独创性:据我们所知,这是埃塞俄比亚首次使用解释现象学方法调查接受胰岛素治疗的2型糖尿病患者的自我护理经历。
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引用次数: 5
Tackling the gender biases in higher education careers in Pakistan: potential online opportunities post COVID-19 解决巴基斯坦高等教育职业中的性别偏见:新冠肺炎后潜在的在线机会
Pub Date : 2021-07-08 DOI: 10.35241/EMERALDOPENRES.14256.1
M. Ashraf, G. Cagliesi, D. Hawkes, M. Rab
Driven to improve the quality of higher education as an engine of growth and socio-economic development within Pakistan for 20 years, the Higher Education Commission (HEC) in Pakistan has focused on linking academics and professional services staff with their counterparts in various countries, including the UK, US, and Australia. In collaboration with the British Council, the PAK-UK initiative has been launched to offer deeper linkages between the academics and universities in the UK and Pakistan. This paper presents statistical analysis of data collected in a British Council project highlighting the gender inequalities of the current HEC strategy. The results suggest the potential for online opportunities to help close and amend this gender gap and improve higher education in Pakistan, and the PAK-UK initiative’s role in contributing more broadly to the United Nations Sustainable Development Goals.
20年来,巴基斯坦高等教育委员会(HEC)一直致力于提高高等教育质量,将高等教育作为巴基斯坦经济增长和社会经济发展的引擎,一直致力于将学术界和专业服务人员与包括英国、美国和澳大利亚在内的各国同行联系起来。在与英国文化协会的合作下,巴基斯坦-英国倡议已经启动,为英国和巴基斯坦的学术界和大学之间提供更深层次的联系。本文对英国文化协会项目收集的数据进行了统计分析,突出了当前高等商学院战略中的性别不平等。研究结果表明,在线机会有可能帮助缩小和弥补这一性别差距,改善巴基斯坦的高等教育,以及巴基斯坦-英国倡议在更广泛地为联合国可持续发展目标做出贡献方面的作用。
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引用次数: 0
The winners and losers in the race to environmental sustainability: a ranking of Summer Olympic International Federation progress 环境可持续性竞赛中的赢家和输家:夏季奥林匹克国际联合会进展排名
Pub Date : 2021-07-07 DOI: 10.35241/EMERALDOPENRES.14195.1
Dominique Santini, Holly Henderson
Purpose: The purpose of this paper is to consolidate knowledge and benchmark the progress being made across the 32 International Federations (IFs) in the Summer Olympic Programme. Design/methodology/approach: A website content analysis, analytical hierarchy of information, and social media research was conducted to triangulate the barriers and drivers of environmental sustainability (ES) progress.  This data was then analysed to empirically substantiate the findings of previous methods by exploring potential drivers of IF ES progress and communication and refining the ranking of IF ES progress. Results and findings: World Sailing is by far the most advanced IF in terms of ES progress, followed by World Athletics. Only 4 out of 32 have any sort of strategic ES plans. Only golf, surfing, football, sailing, and hockey have received any academic attention. There is a significant lack of understanding of environmental practices across sport, and their drivers/barriers. There is limited accountability with regards to ES progress and activities throughout the Olympic Movement. This has resulted in uneven diffusion of environmental activities. Originality: This paper is a new contribution to sport management and ES literature. It provides a benchmark of understanding for ES in the Summer Olympic Programme for the first time using a hierarchy of information to ground results. The exploration and comparison of the perspectives of separate sports adds to the paper's originality.
目的:本文的目的是巩固知识,并衡量32个国际单项体育联合会在夏季奥林匹克项目中取得的进展。设计/方法/方法:进行了网站内容分析、信息层次分析和社交媒体研究,以三角分析环境可持续性进展的障碍和驱动因素。然后对这些数据进行分析,通过探索IF ES进展和沟通的潜在驱动因素,并完善IF ES进展的排名,实证证实了以前方法的发现。结果和发现:就ES进展而言,世界帆船赛是迄今为止最先进的IF,其次是世界田径赛。32人中只有4人有任何战略ES计划。只有高尔夫、冲浪、足球、帆船和曲棍球受到了学术界的关注。人们对体育运动中的环境实践及其驱动因素/障碍缺乏了解。在整个奥林匹克运动中,对ES的进展和活动的问责是有限的。这导致了环境活动的不均衡扩散。原创性:本文是对体育管理和ES文献的新贡献。它首次使用从信息到地面结果的层次结构,为夏季奥运会项目中的ES提供了一个理解基准。对单项体育视角的探索和比较增加了本文的独创性。
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引用次数: 1
COVID-19 lockdown controls and human rights abuses: the socioeconomic and social marketing implications COVID-19封锁控制和侵犯人权:社会经济和社会营销影响
Pub Date : 2021-06-11 DOI: 10.35241/EMERALDOPENRES.13810.2
Ben Odigbo, Felix Eze, R. Odigbo, Joshua Kajang
Background: This work is a situation analysis of reported human rights abuses that have characterized the COVID-19 controls and lockdown in some countries of the world. This is as documented by reliable mass media sources, relevant international organizations and human rights non-governmental organizations between January 2020 to April 2020. Methods: A combined content analysis, critical analysis, and doctrinal method is applied in this study in line with the reproducible research process. It is a secondary-data-based situation analysis study, conducted through a qualitative research approach. Findings: The findings revealed among other things that: COVID-19 lockdowns and curfews’ enforcement by law enforcement officers contravened some peoples’ fundamental human rights within the first month. Security forces employed overt and immoderate forces to implement the orders. The lockdown and curfew enforcements were not significantly respectful of human life and human dignity. The COVID-19 emergency declarations in some countries were discriminatory against minorities and vulnerable groups in some countries. Research limitations/implications: This report is based on data from investigative journalism and opinions of the United Nations and international human rights organizations, and not on police investigations or reports. The implication of the study is that if social marketing orientations and risk communication and community engagement attitudes were given to the law enforcement officers implementing the COVID-19 lockdowns and or curfews, the human rights and humanitarian rights breaches witnessed would have been avoided or drastically minimized. Originality: The originality of this review is that it is the first to undertake a situation analysis of the COVID-19 lockdowns and curfews human rights abuses in some countries. The study portrayed the poor level of social marketing orientations and risk communication and community engagement attitudes amongst law enforcement officers, culminating in the frosty police-public relationships.
背景:这项工作是对世界上一些国家在COVID-19控制和封锁期间报告的侵犯人权行为的情况分析。2020年1月至2020年4月期间,可靠的大众媒体来源、相关国际组织和人权非政府组织都记录了这一点。方法:本研究遵循可重复的研究过程,采用内容分析、批判分析和理论分析相结合的方法。这是一项基于二手数据的情况分析研究,通过定性研究方法进行。调查结果:除其他外,调查结果显示:COVID-19封锁和执法人员实施的宵禁在第一个月内违反了一些人的基本人权。安全部队使用公开和不节制的力量来执行命令。封锁和宵禁的执行没有充分尊重人的生命和人的尊严。一些国家宣布的COVID-19紧急状态是对少数民族和弱势群体的歧视。研究局限/影响:本报告基于调查新闻的数据和联合国和国际人权组织的意见,而不是基于警方的调查或报告。该研究的含义是,如果向实施COVID-19封锁和/或宵禁的执法人员提供社会营销导向、风险沟通和社区参与态度,所目睹的人权和人道主义权利侵犯就可以避免或大大减少。独创性:本审查的独创性在于,它首次对一些国家因COVID-19封锁和宵禁而侵犯人权的情况进行了分析。该研究描述了执法人员在社会营销导向、风险沟通和社区参与态度方面的不良水平,最终导致了冷淡的警民关系。
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引用次数: 4
A community-based participatory research approach to understanding social eating for food well-being 以社区为基础的参与性研究方法来理解社会饮食对食物健康的影响
Pub Date : 2021-06-10 DOI: 10.35241/EMERALDOPENRES.14066.1
Nadina R Luca, Marsha Smith, S. Hibbert
‘Social eating initiatives’ are a specific type of community-based food service that provides opportunities for people to eat together in local spaces using surplus food. These initiatives provide a meal that is fresh, affordable and more environmentally friendly than fast or convenience foods. In this research, we build upon the food well-being model to explore how food consumption is experienced in these community settings and the role of social eating projects in shaping the different dimensions of people’s foodscapes. We adopted a community-based participatory approach and engaged in a series of dialogues with staff volunteers and coordinators at four ‘social eating initiatives’. We also conducted 45 interviews with service users and volunteers at three sites in the Midlands region.   The role of community-based food initiatives responding to hunger by utilising surplus food to feed local populations is often conceptualised critically. The conjoining of food insecurity and surplus food appears to instrumentally feed customers and reduce food wastage, but in ways that are stigmatising, and which position customers as passive recipients of food charity. However, closer attention to the experiences of staff, volunteers and customers at these spaces, reveals them as sites where knowledge and experience of food is being developed with this contributing to a sense of well-being beyond nutrition. Shared food practices and eating together contribute to social capital and are important dimensions of food well-being that are significantly restricted by food insecurity. The ‘food well-being’ model envisages a shift in focus from health, defined as the absence of illness, towards well-being as a positive relationship with food at the individual and societal level. In the concluding remarks of this article, it is suggested that this holistic conception is required to understand the role and function of social eating initiatives.
“社会饮食倡议”是一种特定类型的社区食品服务,它为人们提供了在当地空间一起使用剩余食物的机会。这些举措提供了比快餐或方便食品更新鲜、更实惠、更环保的食物。在本研究中,我们以食物健康模型为基础,探索在这些社区环境中如何体验食物消费,以及社会饮食项目在塑造人们食物景观的不同维度方面的作用。我们采用了以社区为基础的参与式方法,并在四个“社会饮食倡议”中与工作人员志愿者和协调员进行了一系列对话。我们还在米德兰兹地区的三个地点对服务用户和志愿者进行了45次访谈。以社区为基础的粮食倡议通过利用剩余粮食养活当地人口来应对饥饿,其作用往往被批判性地概念化。粮食不安全和粮食过剩的结合似乎有助于为顾客提供食物并减少食物浪费,但其方式是耻辱的,并将顾客定位为食品慈善的被动接受者。然而,仔细观察这些空间的工作人员、志愿者和顾客的经历,就会发现它们是食物知识和经验发展的场所,这有助于提高营养之外的幸福感。共享的食物做法和一起吃饭有助于增加社会资本,是粮食福利的重要方面,但受到粮食不安全的严重限制。“食物健康”模式设想将重点从健康(定义为没有疾病)转向福祉(在个人和社会层面上与食物的积极关系)。在本文的结束语中,建议需要这种整体概念来理解社会饮食倡议的作用和功能。
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引用次数: 0
Portraying gender in external marketing communication, using the example of a fair fashion label 以公平时尚品牌为例,在外部营销传播中描绘性别
Pub Date : 2021-05-20 DOI: 10.35241/EMERALDOPENRES.14090.1
J. Lohmann, M. Schmitz, S. Damme
The topics of gender and sustainability are firmly anchored within a social discourse. Based on both factors, customers are placing demands on companies and have specific ideas on how they should be represented in advertising. The case study presented herein combines these two topics and examines the portrayal of gender in the external marketing communication of the fair fashion label ARMEDANGELS. By analysing individual Instagram publications, the case study identifies how the topic is generally portrayed on the company’s channel. Furthermore, the perspectives of customers are determined through conducted interviews. When comparing the two sides, it becomes apparent that customers mostly approve of the attempt to break with conservative gender roles as well as an equal representation of the male and female personas. In addition to expanding the theoretical considerations of the triple bottom line as well as the S-O-R model, we derive recommendations for ARMEDANGELS and for other companies in the fashion industry. For customer retention purposes, companies should therefore focus on aligning the sexes, breaking with the general gender binary and integrating LGBTQ+ communities in future marketing measures.
性别和可持续性的主题牢牢地固定在社会话语中。基于这两个因素,客户对公司提出了要求,并对如何在广告中代表他们有了具体的想法。本文的案例研究结合了这两个主题,并考察了公平时尚品牌ARMEDANGELS的外部营销传播中的性别形象。通过分析个人Instagram出版物,案例研究确定了该主题在公司频道上的总体描述。此外,客户的观点是通过进行访谈来确定的。当比较双方时,很明显,客户大多赞成打破保守的性别角色以及男女角色平等代表的尝试。除了扩展三重底线和S-O-R模型的理论考虑外,我们还为ARMEDANGELS和时尚行业的其他公司提出了建议。因此,为了留住客户,公司应该专注于调整性别,打破一般的性别二元对立,并在未来的营销措施中整合LGBTQ+社区。
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引用次数: 2
Urban agriculture in times of crisis: the role of home food growing in perceived food insecurity and well-being during the early COVID-19 lockdown 危机时期的城市农业:在新冠肺炎早期封锁期间,家庭食品在感知粮食不安全和福祉中的作用
Pub Date : 2021-05-04 DOI: 10.35241/emeraldopenres.14186.1
B. Mead, Jessica A. C. Davies, N. Falagán, S. Kourmpetli, Lingxuan Liu, C. Hardman
Household food insecurity and poor well-being have increased during the coronavirus disease 2019 (COVID-19) pandemic and resulting lockdown measures. Home food growing has been associated with improved food access and well-being, but it is unknown what role it plays during food supply crises and lockdown. It is also unclear how home food growing and social restrictions may affect opinions about growing food in urban areas (i.e., urban agriculture [UA]). A cross-sectional online survey was conducted during the UK national lockdown in March-April 2020 to measure home food growing, perceived food insecurity, well-being, and opinions of UA. The participants were 477 UK-based adults (369 female, mean age 39.57 years ± 13.36); 152 participants were engaged in home food growing prior to the pandemic. Responses were compared to data collected from a separate sample of participants before the pandemic ( N = 583) to explore potential shifts in opinions about UA. Participants who engaged in home food growing had lower levels of food insecurity ( U = 19894.50, z = -3.649, p<.001, r = -.167) and higher well-being ( U = 19566.50, z = -3.666, p<.001, r = -.168) than those not engaged in home food growing. Perceived food insecurity partially mediated the relationship between home food growing and well-being; home food growing was associated with less food insecurity, which in turn was associated with better well-being. There were no differences in opinions of UA compared to the sample of participants from before the pandemic. Home food growing may have had a protective effect over perceived food security and well-being in the early stages the pandemic. Opinions of UA were positive and unchanged compared to data collected pre-pandemic. Policies that support home food growing and access to suitable growing spaces and resources may be beneficial for food system resilience and well-being.
在2019冠状病毒病(新冠肺炎)大流行和由此导致的封锁措施期间,家庭粮食不安全和贫困状况加剧。家庭粮食种植与改善粮食获取和福祉有关,但尚不清楚它在粮食供应危机和封锁期间发挥了什么作用。目前还不清楚家庭食品种植和社会限制如何影响对城市地区(即城市农业[UA])种植食品的看法。在2020年3月至4月英国全国封锁期间,进行了一项横断面在线调查,以衡量家庭粮食增长、感知的粮食不安全、幸福感和UA的意见。参与者是477名英国成年人(369名女性,平均年龄39.57岁±13.36岁);152名参与者在疫情之前参与了家庭食品种植。将反应与疫情前从单独的参与者样本中收集的数据进行比较(N=583),以探索对UA的看法可能发生的变化。与不参与家庭粮食种植的参与者相比,参与家庭粮食生产的参与者的粮食不安全程度较低(U=19894.50,z=-3.649,p<.001,r=-1.167),幸福感较高(U=19566.50,z=-3.666,p<0.001,r=-.168)。感知到的粮食不安全在一定程度上调节了家庭粮食种植与幸福感之间的关系;家庭粮食种植与减少粮食不安全有关,而粮食不安全又与改善福祉有关。与疫情前的参与者样本相比,UA的意见没有差异。在疫情早期,家庭粮食种植可能对感知到的粮食安全和福祉产生了保护作用。UA的意见是积极的,与疫情前收集的数据相比没有变化。支持家庭粮食种植和获得适当种植空间和资源的政策可能有利于粮食系统的恢复力和福祉。
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引用次数: 5
Going virtual: adapting in-person interactive focus groups to the online environment 走向虚拟:使面对面的互动焦点小组适应在线环境
Pub Date : 2021-04-23 DOI: 10.35241/EMERALDOPENRES.14163.1
Jonathan Menary, S. Stetkiewicz, Abhishek Nair, P. Jorasch, A. Nanda, A. Guichaoua, M. Rufino, A. Fischer, J. Davies
Restrictions on social interaction and travel due to the COVID-19 pandemic have affected how researchers approach fieldwork and data collection. Whilst online focus groups have received attention since the 2000s as a method for qualitative data collection, relatively little of the relevant literature appears to have made use of now ubiquitous video calling software and synchronous, interactive discussion tools. Our own experiences in organising fieldwork aimed at understanding the impact of different ‘future-proofing’ strategies for the European agri-food system during this period resulted in several methodological changes being made at short notice. We present an approach to converting in-person focus group to a virtual methodology and provide a checklist for researchers planning their own online focus groups. Our findings suggest data are comparable to in-person focus groups and factors influencing data quality during online focus groups can be safeguarded. There are several key steps, both before and during the focus groups, which can be taken to ensure the smooth running of such events. We share our reflections on this approach and provide a resource for other researchers moving to online-only data collection.
新冠肺炎大流行对社交和旅行的限制影响了研究人员如何进行实地调查和数据收集。尽管自2000年代以来,在线焦点小组作为一种定性数据收集方法受到了关注,但似乎很少有相关文献使用现在无处不在的视频通话软件和同步互动讨论工具。我们自己组织实地调查的经验旨在了解这一时期不同的“未来证明”策略对欧洲农业食品系统的影响,这导致了在短时间内做出了一些方法上的改变。我们提出了一种将面对面焦点小组转换为虚拟方法的方法,并为研究人员规划自己的在线焦点小组提供了一份清单。我们的研究结果表明,数据与面对面焦点小组相当,在线焦点小组期间影响数据质量的因素可以得到保护。在焦点小组之前和期间,可以采取几个关键步骤来确保此类活动的顺利进行。我们分享了我们对这种方法的思考,并为其他研究人员转向仅在线数据收集提供了资源。
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引用次数: 15
"The reality is that on Universal Credit I cannot provide the recommended amount of fresh fruit and vegetables per day for my children": Moving from a behavioural to a systemic understanding of food practices [version 1; peer review: 2 approved]. “现实情况是,通过通用信贷,我无法为我的孩子提供每天推荐量的新鲜水果和蔬菜”:从对饮食习惯的行为理解转向系统理解[版本1;同行评议:[2]。
Pub Date : 2021-02-18 DOI: 10.35241/emeraldopenres.14062.1
Maddy Power, Katie J Pybus, Kate E Pickett, Bob Doherty

Background: Evidence suggests that people living in poverty often experience inadequate nutrition with short and long-term health consequences. Whilst the diets of low-income households have been subject to scrutiny, there is limited evidence in the UK on the diet quality and food practices of households reporting food insecurity and food bank use. We explore lived experiences of food insecurity and underlying drivers of diet quality among low-income families, drawing upon two years of participatory research with families of primary school age children.

Methods: We report on a mixed-methods study of the relationship between low income, food bank use, food practices and consumption from a survey of 612 participants, including 136 free text responses and four focus groups with 22 participants. The research followed a parallel mixed-methods design: qualitative and quantitative data were collected separately, although both were informed by participatory work. Quantitative data were analysed using binary and multinomial logistic regression modelling; qualitative data were analysed thematically.

Results: Lower income households and those living with food insecurity struggle to afford a level of fruit and vegetable consumption that approaches public health guidance for maintaining a healthy diet, despite high awareness of the constituents of a healthy diet. Participants used multiple strategies to ensure as much fruit, vegetable and protein consumption as possible within financial constraints. The quantitative data suggested a relationship between higher processed food consumption and having used a food bank, independent of income and food security status.

Conclusions: The findings suggest that individualised, behavioural accounts of food practices on a low-income misrepresent the reality for people living with poverty. Behavioural or educational interventions are therefore likely to be less effective in tackling food insecurity and poor nutrition among people on a low income; policies focusing on structural drivers, including poverty and geographical access to food, are needed.

背景:有证据表明,生活在贫困中的人往往营养不足,造成短期和长期的健康后果。虽然低收入家庭的饮食一直受到审查,但在英国,报告食物不安全和食物银行使用情况的家庭的饮食质量和饮食习惯的证据有限。通过对小学适龄儿童家庭进行为期两年的参与性研究,我们探索了低收入家庭中粮食不安全的生活经历和饮食质量的潜在驱动因素。方法:我们报告了一项混合方法研究低收入,食品银行使用,食品实践和消费之间的关系,来自612名参与者的调查,包括136个免费文本回复和4个焦点小组22名参与者。该研究采用平行混合方法设计:分别收集定性和定量数据,尽管两者都通过参与性工作获得信息。定量数据采用二元和多项logistic回归模型进行分析;对定性数据进行专题分析。结果:低收入家庭和那些生活在粮食不安全状况下的人,尽管对健康饮食的成分有很高的认识,但仍难以负担接近维持健康饮食的公共卫生指导的水果和蔬菜消费水平。参与者使用多种策略来确保在经济紧张的情况下尽可能多地食用水果、蔬菜和蛋白质。定量数据表明,高加工食品消费量与使用食品银行之间存在关系,与收入和粮食安全状况无关。结论:研究结果表明,对低收入人群饮食习惯的个性化行为描述歪曲了生活贫困人群的现实。因此,行为或教育干预措施在解决低收入人群的粮食不安全和营养不良问题方面可能效果较差;需要制定侧重于结构性驱动因素的政策,包括贫困和粮食的地理可及性。
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引用次数: 10
Hyperglycemia in pregnancy diagnosed using glycated hemoglobin (HbA1c) in Uganda: a preliminary cross-sectional report 在乌干达使用糖化血红蛋白(HbA1c)诊断妊娠高血糖:一个初步的横断面报告
Pub Date : 2020-12-15 DOI: 10.35241/emeraldopenres.14014.1
F. Bongomin, A. Kyazze, Sandra Ninsiima, R. Olum, Gloria Nattabi, Winnie Nabakka, R. Kukunda, C. Batte, P. Ssekamatte, J. Baluku, D. Kibirige, S. Cose, I. Andia-Biraro
Background: Hyperglycemia in pregnancy (HIP) is a common medical complication during pregnancy and is associated with several short and long-term maternal-fetal consequences. We aimed to determine the prevalence and factors associated with HIP among Ugandan women. Methods: We consecutively enrolled eligible pregnant women attending antenatal care at Kawempe National Referral Hospital, Kampala, Uganda in September 2020. Mothers known to be living with diabetes mellitus or haemoglobinopathies and those with anemia (hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and glycated hemoglobin A1c (HbA1c) were measured on peripheral venous blood samples. HIP was defined as an HbA1c ≥5.7% with its subsets of diabetes in pregnancy (DIP) and prediabetes defined as HbA1c of ≥6.5% and 5.7-6.4% respectively. ROC curve analysis was performed to determine the optimum cutoff of RBS to screen for HIP. Results: A total of 224 mothers with a mean (± SD) age 26±5 years were enrolled, most of whom were in the 2nd or 3rd trimester (94.6%, n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of HIP was 11.2% (n=25) (95% CI: 7.7-16.0). Among the mothers with HIP, 2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP were older (28 years vs. 26 years, p=0.027), had previous tuberculosis (TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p = 0.032). However only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI: 1.2-14.0; p=0.022). Using HbA1c as a reference variable, we derived an optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a sensitivity and specificity of 90.7% and 56.4% (area under the curve = 0.75 (95% CI: 0.70-0.80, p<0.001)), respectively. Conclusions: HIP is common among young Ugandan women, the majority of whom are without identifiable risk factors.
背景:妊娠期高血糖症(HIP)是妊娠期常见的医学并发症,与多种短期和长期母胎后果相关。我们的目的是确定乌干达妇女HIP的患病率和相关因素。方法:我们连续招募了2020年9月在乌干达坎帕拉Kawempe国家转诊医院接受产前护理的符合条件的孕妇。已知患有糖尿病或血红蛋白病和贫血(血红蛋白<11g/dl)的母亲被排除在外。测定外周静脉血随机血糖(RBS)和糖化血红蛋白(HbA1c)。HIP定义为HbA1c≥5.7%,其亚群妊娠期糖尿病(DIP)和糖尿病前期分别定义为HbA1c≥6.5%和5.7-6.4%。采用ROC曲线分析确定RBS筛选HIP的最佳截止点。结果:共纳入224例产妇,平均(±SD)年龄为26±5岁,其中大部分为妊娠二、晚期(94.6%,n=212),平均胎龄为26.6±7.3周。HIP患病率为11.2% (n=25) (95% CI: 7.7-16.0)。在HIP的母亲中,2.2% (n=5)患有DIP, 8.9% (n=20)患有前驱糖尿病。HIP患者年龄较大(28岁对26岁,p=0.027),既往有结核病(TB)接触史(24%对6.5%,p=0.003),臀围较大(107.8(±10.4)比103.3(±9.7)cm, p= 0.032)。然而,只有既往结核病接触可预测HIP(优势比:4.4,95% CI: 1.2-14.0;p = 0.022)。以HbA1c作为参考变量,我们得出了预测HIP的最佳RBS截止值为4.75 mmol/L,灵敏度和特异性分别为90.7%和56.4%(曲线下面积= 0.75 (95% CI: 0.70-0.80, p<0.001))。结论:HIP在乌干达年轻女性中很常见,其中大多数没有可识别的危险因素。
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引用次数: 1
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Emerald open research
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