Prevalence of Diabetic Nephropathy and Factors Predicting Diabetic Nephropathy among Type 2 Diabetes Mellitus Patients in Public Health Centers, Bangkok Metropolitan
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Abstract
Purpose: To explore the prevalence of diabetic nephropathy and to examine the predictive power of factors in terms of HbA1C, FBS, blood pressure, health behavior, health literacy, genetics, and income on the occurrence of diabetic nephropathy among type 2 diabetes mellitus patients at public health centers, Bangkok Metropolitan area.
Design: A survey research and cross-sectional descriptive study were employed in this study.
Methods: A survey research design was conducted to explore the prevalence of diabetic nephropathy among 1,084 participants. Data were collected from medical chart reviews during January 1st to December 31st, 2018. A cross-sectional descriptive study design was then performed to examine the predictive power of HbA1C, FBS, blood pressure, health behavior, health literacy, genetics, and income on the occurrence of diabetic nephropathy. Data were collected from 175 participants using self-report questionnaires. Then data were analyzed using descriptive statistics and logistic regression analysis.
Main findings: This study revealed that the prevalence of diabetic nephropathy was 363 per 1,000 people. The majority of participants were females (66.0%). The mean age was 67.3 years (SD = 8.9). Logistic regression analysis found that HbA1c, FBS, blood pressure, health behavior, health literacy, genetics, and income could together predict the occurrence of diabetic nephropathy among type 2 diabetes mellitus patients by 45.6% (R2 = .456). HbA1c, health behavior, health literacy, and income could predict the risk of diabetic nephropathy by 2.0, 0.8, 0.9, and 0.1 times respectively.
Conclusion and recommendation: The study could be concluded that the prevalence of diabetic nephropathy was high. Patients who could not control HbA1c, having low score of health behavior and health literacy, and having low income were more likely to have a risk for diabetic nephropathy. This study provided important information, which could be used for performing quality improvement and developing diabetic nephropathy programs/ interventions to prevent or delay complications for type 2 diabetes mellitus patients.
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References
Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health. Annual epidemiological surveillance report 2016 [Internet]. Nonthaburi: Bureau of Epidemiology; 2016 [cited 2018 Sep 10]. Available from: https://apps.boe.moph.go.th/boeeng/annual/AESR2016/index.html. (in Thai).
Rattarasarn C. Current situation and cooperation for reform of disease care diabetes in Thailand [Internet]. Bangkok: Novo Nordisk Pharma (Thailand); 2017 [cited 2018 Nov 10]. Available from: https://www.novonordisk.com/content/dam/Denmark/HQ/sustainablebusiness/performance-on-tbl/more-about-how-we-work/Creating%20shared%20value/PDF/Thailand%20Blueprint%20for%20Change_2017_TH.pdf. (in Thai).
The Nephrology Society of Thailand. Clinical practice recommendation for the evaluation and management of chronic kidney disease in adults 2015. Bangkok: Takeda; 2015. 26 p. (in Thai).
Pichaiwong W. Diabetic nephropathy. Journal of the Department of Medical Services. 2015;40(5):19-24. (in Thai).
Sornchanani C. Lessons of challenges in taking care of chronic kidney disease patients: palliative care [Internet]. Bangkok: National Health Security Office; 2017 [cited 2018 Nov 10]. Available from: http://www.thaps.or.th/wp-content/uploads/2017/09/CKDPaliiative-Care.pdf. (in Thai).
Teliti M, Cogni G, Sacchi L, Dagliati A, Marini S, Tibollo V, et al. Risk factors for the development of micro-vascular complications of type 2 diabetes in a single-centre cohort of patients. Diab Vasc Dis Res. 2018;15(5):424‐32. doi: 10.1177/1479164118780808.
Al-Rubeaan K, Siddiqui K, Alghonaim M, Youssef AM, AlNaqeb D. The Saudi Diabetic Kidney Disease study (Saudi-DKD): clinical characteristics and biochemical parameters. Ann Saudi Med. 2018;38(1):46‐56. doi: 10.5144/0256-4947.2018.03.01.1010.
Janjumras K, Pipatsatitpong D. Prevalence of diabetic nephropathy in type 2 diabetes mellitus at Somdejprapinklao Hospital. Journal of the medical technologist association of Thailand. 2016;44(1):5508-21. (in Thai).
Phuwong Y, Pinitsoontorn S. Complication among diabetes patients in a selected community hospital in the Northeast. Community Health Development Quarterly Khon Kaen University. 2014;2(3):311-19. (in Thai).
Arambewela MH, Somasundaram NP, Jayasekara HBPR, Kumbukage MP, Jayasena PMS, Chandrasekara CMPH, et al. Prevalence of chronic complications, their risk factors, and the cardiovascular risk factors among patients with type 2 diabetes attending the diabetic clinic at a tertiary care hospital in Sri Lanka. J Diabetes Res. 2018;2018:4504287. doi: 10.1155/2018/4504287.
Molefe-Baikai OJ, Molefi M, Cainelli F, Rwegerera GM. The prevalence of microalbuminuria and associated factors among patients with type 2 diabetes mellitus in Botswana. Niger J Clin Pract. 2018;21(11):1430‐7. doi: 10.4103/njcp.njcp_224_18.
Ansar MM, ShahrokhiRad R, Lebady MK. Risk factors of microalbuminuria and macroalbuminuria in type 2 diabetic patients in North of Iran-Rasht. Nephrourol Mon. 2017;9(1):e40031. doi: 10.5812/numonthly.40031.
Ahmed MA, Kishore G, Khader HA, Kasturirangan MN. Risk factors and management of diabetic nephropathy. Saudi J Kidney Dis Transpl. 2013;24(6):1242‐7. doi: 10.4103/1319-2442.121310.
Health Education Division, Department of Health Service Support, Ministry of Public Health. Strategies for promoting health literacy and health behavior. Bangkok: Health Education Division; 2018. 88 p. (in Thai).
Thungtong S. Delayed progression diabetic nephropathy in patients with uncontrolled type 2 diabetes mellitus. Journal of The Royal Thai Army Nurses. 2017;18 Suppl 2:17-24. (in Thai).
Dechma J, Durongritichai V, Kijtorntham V. A study of predictable factors of diabetes mellitus complication in the community under King’s nursing theory. Journal of Public Health Nursing. 2013;27(2):63-80. (in Thai).
Rattanawarang W, Chantha W. Health literacy of self-care behaviors for blood glucose control in patients with type 2 diabetes, Chainat Province. The Journal of Baromarajonani College of Nusing, Nakhonratchasima. 2018;24(2):34-51. (in Thai).
Lohsoonthorn V. Epidermiology. Bangkok: Chulalongkorn University; 2018. 359 p. (in Thai).
Srisatidnarakul B. The methodology in nursing research. 5th ed. Bangkok: Chulalongkorn University; 2010. 568 p. (in Thai).
Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373-9. doi: 10.1016/s0895-4356(96)00236-3.
Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, et al. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25(6):391‐5.
Kaeodumkoeng K. Health literacy: access, understand and application. 2th ed. Bangkok: Amarin Printing and Publishing; 2018. 215 p. (in Thai).
Radwan M, Elsous A, Al-Sharif H, Abu Mustafa A. Glycemic control among primary care patients with type 2 diabetes mellitus in the Gaza Strip, Palestine. Ther Adv Endocrinol Metab. 2018;9(1):3-14. doi: 10.1177/2042018817742070.
Ginggeaw S, Prasertsri N. The relationship between health literacy and health behaviors among older adults who have multi-morbidity. Nursing Journal of the Ministry of Public Health. 2016;25(3):43-54. (in Thai).
Lee SJ, Chung CW. Health behaviors and risk factors associated with chronic kidney disease in Korean patients with diabetes: the Fourth Korean National Health and Nutritional Examination Survey. Asian Nurs Res. 2014;8(1):8-14. doi: 10.1016/j.anr.2013.11.001.
Geetha A, Gopalakrishnan S, Umadevi R. Study on the impact of family history of diabetes among type 2 diabetes mellitus patients in an urban area of Kancheepuram district, Tamil Nadu. Int J Community Medicine and Public Health. 2017;4(11):4151-6. doi: 10.18203/2394-6040.ijcmph20174819.