PREVALENCE OF DIABETES MELLITUS IN TUBERCULOSIS PATIENT

18

Background of the study

 

Diabetes Mellitus (DM) a metabolic disorder of the pancreas has emerged as one of the public health challenges in recent times. Of the three major types of DM, type-2 diabetes mellitus (T2DM) has emerged as the most prevalent accounting for between 85 to 95% of all DM cases worldwide. Kumar , Ankushe , Doibale (2018)

 

Diabetes mellitus (DM) can be described as a group of metabolic diseases indicated by chronic hyperglycemia resulting from impaired insulin secretion, action or both. There are a number of pathogenic pathways by which diabetes can develop, resulting in different types of DM with the common ones being type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) Kharroubi (2018). T2DM is the most common type of DM; 90% of DM cases are T2DM. It is also known as non-insulin dependent diabetes. By the year 2030, it is estimated that 439 million people will acquire T2DM Ong and Lai (2017).

 

According to a study done in 2016 on 2082 participants, the prevalence of diabetes in Brunei Darussalam was 9.7% in which diabetes was indicated as having fasting blood glucose ≥7.0 mmol/L. It has been stated that despite the success in controlling communicable diseases, there was an epidemic of non-communicable diseases (NCDs) in the sultanate, including T2DM. The prevalence of diabetes in Brunei Darussalam is lower in comparison to the neighbouring countries, Singapore and Malaysia, with 11% and 18% of diabetes prevalence, respectively. However, considering that obesity has been linked to be a risk factor for T2DM, the prevalence of obesity in Brunei Darussalam, 28%, ranks highest among Southeast Asian countries. A weighted measurement by the study had confirmed the extensive presence of key risk factors, such as smoking and obesity, and morbidities in relation to NCD in Brunei Darussalam. The standardized methodology used in the study is important for the surveillance of public health interventions as it provides policy makers with the ability to better evaluate public health needs, identify priority settings and set proper and relevant objectives Ong, and Lai (2017)

 

Diabetes mellitus has been the third leading cause of death in Brunei Darussalam since 2012, accounting for 10.1% of the total deaths nationwide in 2017. This is an increase from the 2016 mortality rate from diabetes mellitus, which was 9.1%.

 

Despite the efforts made by the government, there is still the need to involve other relevant stakeholders to cooperate and engage in these pursuits to raise diabetes awareness, empower the people to make healthy decisions, and ultimately control the prevalence of diabetes in Brunei Darussalam (Brudirect, 2022).

 

Patients’ knowledge in compliance towards the management of DM is necessary by patient on their medication for correct use. This includes the therapeutic goal, dosage, times to take it, safety, and its conservation methods in addition to possible interactions and adverse reactions.

 

Patient’s compliance can be measured by the accuracy, regularity and willingness he/she demonstrates in execution of the prescribed therapeutic regimen in terms of taking medications, following diet, keeping appointments, and executing other lifestyle changes Paola,  Fernanda Pinto et al (2018) . Many causes may underlie poor compliance. These include forgetfulness, poor rapport with physician, few symptoms, concomitant chronic illness, perceived lack of effect, real or perceived side-effects, unclear instructions or purpose of treatment. They may also involve physical difficulties such as opening medicine containers, handling small tablets, swallowing difficulties, and travel to place of treatments.

Poor patient medication knowledge may result in a decrease in medication’s effectiveness, the emergence of other health issues, medication misuse, as well as negative results linked to medication such as adverse drug reaction Gudeta, Mechal (2019). Adverse drug reaction is considered as an important public health concern as its incidence is prevalent.

Sound medication knowledge has been demonstrated to be positively corresponded with a better quality of life, treatment compliance, and achieving desirable results in pharmacotherapy. This is therefore crucial in disease management and in combating the frequency of adverse drug reactions Rubio, García-Delgado, Iglésias, Mateus, Martínez,(2015). One of the prerequisites for a patient’s involvement in reducing medication error is proper patient education. Despite this, there is not much research that assesses patient medication knowledge in hospitals. A large number of outpatients are subjected to polypharmacy and this can increase the risk of other health issues such as drug interactions and the possibility of toxicity Ramia, E.; Zeenny, R.M.; Hallit, S.; Salameh(2017). To further examine the aforementioned issues, the objectives of this project were to evaluate Prevalence of diabetes mellitus in tuberculosis patien