Comparison of Lifestyle Pattern between Controlled and UncontrolledType- II Diabetes Mellitus Patients

INTRODUCTION

Diabetes mellitus is a serious illness that imposes a tremendous health and social burden worldwide1 and type-II diabetes mellitus is the leading cause of premature death. India is the diabetic capital of the world.2 The high incidence of diabetes in India is mainly because of sedentary lifestyle, lack of physical activity, obesity, stress and consumption of diets rich in fats, sugar and calories.Diabetes mellitus requires continuous care, as they require to exert some control over the maintenance of their disease, if they want to achieve stable health.³ A study on factors associated with poor glycemic control among patients with Type-II diabetes was conducted at Jorden. For the study using systematic random sampling technique, 917 patients were included. The results showed that, the poor glycemic control was more common among patients who did not follow dietary regimens, did not practice any physical activity, who were not adherent for medications and did not regularly perform home glucose monitoring⁴ . A comparative study on glycemic control and incidence of retinopathy was conducted between Controlled and Uncontrolled Type II DM in India and Karnataka respectively. The result showed that there was a good glycemic control and less incidence of retinopathy was found in Controlled diabetes then Uncontrolled diabetics. Hence the study was undertaken to compare the lifestyle patterns between Controlled and Uncontrolled type-II Diabetes mellitus patients^5,6.

OBJECTIVES

1. Determine the lifestyle patterns of Controlled and Uncontrolled Type-II Diabetes Mellitus patients by using bio physiological parameters and checklist.

2. Compare the life style patterns of Uncontrolled Type-II Diabetes Mellitus with that of Controlled Type-II Diabetes Mellitus patients.

3. To identify the relationship of lifestyle patterns of Controlled and Uncontrolled Type-II Diabetes Mellitus patients with selected SocioDemographic variables like age, gender, literacy, occupation, income, habits, duration of diagnosis of DM. 

MATERIALS AND METHODS

This study was based on Concept, Input, Process and Product (CIPP) model on evaluation developed by Daniel Stufflebean (2003). The design used for the study was a Cross Sectional descriptive research design. Based on objectives of the study, bio physiological parameters on lab reports and checklist on interview schedule and a health education pamphlet was prepared in English and then it was translated to Kannada since the study participants communication and understanding were only in Kannada. The tool and health education pamphlet were validated by eight research and subject experts for its adequacy and appropriateness. After obtaining an ethical clearance from an institutional ethical committee, a formal written permission was obtained from the Medical Superintendent of R.L Jalappa hospital and Research Centre. After taking consent from Type II Diabetes Mellitus patients, through purposive sampling technique 50 patients were included under Controlled Type II DM group whose fasting blood sugar level was 80-130mg/dl and Post Prandial blood sugar level was less than 150mg/dl and 50 patients were included under Uncontrolled Type II DM group whose fasting blood sugar level was more than 130mg/dl, Post Prandial blood sugar level was more than 190mg/dl and HbA1c was more than 7%. Then both groups were assessed for their bio-physiological parameters through lab reports and lifestyle pattern through checklist. A health education pamphlet on life style patterns to control Diabetes mellitus was distributed to all Uncontrolled Type II DM patients.

RESULTS

I. Socio-demographic variables

With regard to socio-demographic variables, majority (54% in Controlled and 58% in Uncontrolled) of Type II DM patients belonged to the age group of 41 to 60years, most (68% in Controlled and 52% in Uncontrolled) were male, majority 44% in Controlled Type II DM werehigh school educated, 50% in Uncontrolled Type II DM were Primary school educated, majority (80% in Controlled and 86% in Uncontrolled Type II DM) of them were self-employed, majority (62% in Controlled and 86% in Uncontrolled Type II DM) of them were having less than Rs.5000/- per month, majority (34% in Controlled and Uncontrolled ) had no habits, (28% in Controlled and 34% in Uncontrolled) of them were tobacco users, 52% in Controlled and 74% in Uncontrolled were Diabetic for >3 years. (Table-1)

II. Biophysiological parameters of Controlled and Uncontrolled Type II DM patients

With regard to biophysiological parameters of Type II DM patients, the obtained mean value of FBS in the Controlled Type II Diabetes Mellitus patients was 126.6 with SD of 4.94 where as in the Uncontrolled Type II Diabetes Mellitus patients the mean value of FBS was 174 with SD of 15.6. The obtained mean value of PPBS in the Controlled Type II Diabetes Mellitus patients was 134.6 with SD of 10.03 where as in the Uncontrolled Type II Diabetes Mellitus patients the mean value of PPBS was 311 with SD of 72.3.  

The obtained mean value of HbA1c in the Controlled Type II Diabetes Mellitus patients was 6.15 with SD of 0.2 where as in the Uncontrolled Type II Diabetes Mellitus patients the mean value of HbA1c was 7.98 with SD of 0.8. (Table 2)

III. Distribution of Type II DM patients according to lifestyle Pattern

The lifestyle patterns data related to diet, medications, exercises and alternative therapy was conducted and it revealed that theControlled Type II DM patients were following much better lifestyle patterns compared to Uncontrolled Type II DM patients. (Table 3)

IV. Comparison of lifestyle patterns of Uncontrolled Type-II Diabetes Mellitus with that of Controlled Type-II Diabetes Mellitus patients.

Comparison of overall mean value of Type II DM patients was done between Controlled Type II DM and Uncontrolled Type II DM (Table 4). The mean difference of lifestyle patterns of Controlled Type II DM patients 11.86 was more than mean difference of Uncontrolled Type II DM patients 8.32 .Hence the Controlled Type II DM patients had much better lifestyle patterns than Uncontrolled Type II DM patients. The obtained t-value was 11.06, which was greater than table value (1.96) at 0.05 level of significance.

IV. Association of lifestyle patterns of Controlled and Uncontrolled Type-II Diabetes Mellitus patients with selected Socio-Demographic variables

The associations of lifestyle patterns of Type II DM patients were tested by using chi-square and fisher’s exact test. There was no association of lifestyle patterns of Controlled and Uncontrolled Type-II DM patients with socio-demographic variablessuch as age, gender, literacy, occupation, income, habits, and duration of diagnosis of DM.  

DISCUSSION

The present study was undertaken to compare the life Style Patterns of Controlled and Uncontrolled Type- II Diabetes mellitus patients The findings of socio-demographic variables of Controlled and Uncontrolled Type II DM patients revealed that majority of them were between 41 to 60 years of age group, most of them were males. This finding was supported by the study conducted by Deepa et al (2003) on the epidemiology of Diabetes Mellitus showed that majority (52.8%) were males and 47.2% were females. Comparison of overall mean value of Type II DM patients was done between Controlled Type II DM and Uncontrolled Type II DM. The mean difference of lifestyle patterns of Controlled Type II DM patients 11.86 was more than mean difference of Uncontrolled Type II DM patients 8.32. This indicated that Controlled Type II DM patients followed much better lifestyle patterns than Uncontrolled Type II DM patients. It was supported by the study conducted by Preha Singh, Veerendra Kumar Arumalla on Comparison of Lipid Profile between Controlled and Uncontrolled Type-II Diabetic patients in India revealed that total serum cholesterol, Triglyceride, LDL-C and low HDL-C were observed in Type II Diabetics with poor glycemic control compared to patients with good glycemic control⁵ . Further it was observed that Uncontrolled patients were looking tired and sick appearance than controlled Type II DM patients.

LIMITATIONS

The study was limited only to the Type II Diabetes Mellitus patients who are attending OPD and admitted at R.L.Jalappa hospital and Research centre, Tamaka, Kolar.

CONCLUSION

The study on lifestyle patterns among Controlled and Uncontrolled Type-II Diabetes Mellitus patients revealed that Controlled Type II DM patients were following much better lifestyle patterns than Uncontrolled Type II DM patients. Hence the study concludes that adequate information, motivation and counseling are essential for Type II DM patients in order to practice healthy lifestyle pattern in day to day life and to prevent further complications.