Mosha Theobald C E, Rashidi Heri
Department of Food Science and Nutrition, Sokoine University of Agriculture, Morogoro, Tanzania.
Ecol Food Nutr. 2009 Mar-Apr;48(2):89-111. doi: 10.1080/03670240802577457.
This study was conducted to determine self-care practices and diabetes related emotional distress among people with Type 2 diabetes mellitus in Dar es Salaam, Tanzania. A cross sectional survey-involving 121 Types 2 diabetics was conducted in 4 diabetic clinics located in Dar es Salaam. Anthropometric and biomedical measurements namely weight, height, waist, hip, mid-upper arm circumference, blood pressure and fasting blood glucose were measured. Self-care practices and diabetic related emotion distress were evaluated by using validated instruments. Results revealed that, the average fasting plasma glucose was 11.2 ± 5.5 mmol/l, blood pressure was 134.7/86.1 mm/Hg and the mean BMI for males and females were 25.0 ± 4.3 and 27.0 ± 5.1 kg/m(2), respectively. Subject's self-care score for general diet, specific diet, physical exercise, foot-care and medication were 4.6 ± 2.4, 3.7 ± 1.5, 3.4 ± 1.8, 3.6 ± 2.8 and 5.5 ± 2.8 days per week, respectively. Self-monitoring of blood glucose was irregular and only 46.3% of the subjects tested their levels of blood glucose at least once in between the appointments (90 days). Low income was the major limitation for complying with the self-care practices related to diet, blood glucose testing and medication. It is recommended that, the Government of Tanzania should in the short run subsidize the prices of diabetes drugs, remove all taxes on the glucose test kits and establish a national diabetes program that would coordinate and oversee provision of the basic services such as screening, glucose testing, medication, counseling and management of the condition. In the long run, the government should establish a preventive public health program in order to curtail the escalation of diabetes. Further research should be conducted to determine how factors such as socio-cultural and demographic, self-care, and psychosocial distress interact to determine biomedical outcomes such as blood pressure, blood glucose and body mass index.
本研究旨在确定坦桑尼亚达累斯萨拉姆2型糖尿病患者的自我护理行为及与糖尿病相关的情绪困扰。在达累斯萨拉姆的4家糖尿病诊所对121名2型糖尿病患者进行了横断面调查。测量了人体测量学和生物医学指标，即体重、身高、腰围、臀围、上臂中部周长、血压和空腹血糖。使用经过验证的工具评估自我护理行为和与糖尿病相关的情绪困扰。结果显示，平均空腹血糖为11.2±5.5 mmol/l，血压为134.7/86.1 mmHg，男性和女性的平均BMI分别为25.0±4.3和27.0±5.1 kg/m²。受试者在一般饮食、特殊饮食、体育锻炼、足部护理和药物治疗方面的自我护理得分分别为每周4.6±2.4天、3.7±1.5天、3.4±1.8天、3.6±2.8天和5.5±2.8天。血糖自我监测不规律，只有46.3%的受试者在预约就诊期间（90天）至少检测过一次血糖水平。低收入是遵守饮食、血糖检测和药物治疗等自我护理行为的主要限制因素。建议坦桑尼亚政府短期内补贴糖尿病药物价格，取消血糖检测试剂盒的所有税费，并建立一个国家糖尿病项目，以协调和监督提供筛查、血糖检测、药物治疗、咨询和病情管理等基本服务。从长远来看，政府应建立预防性公共卫生项目，以遏制糖尿病的蔓延。应进一步开展研究，以确定社会文化和人口统计学、自我护理以及心理社会困扰等因素如何相互作用，从而决定血压、血糖和体重指数等生物医学指标。
