The Community Pharmacists’ Role Enhancing Medicines Management for Type II Diabetes in Tripoli, Libya. A Randomised Controlled Trial in Community Pharmacy to Investigate Knowledge and Practice in Relation To Type II Diabetes and Glycaemic Control
AuthorElhatab, Nesrin M.
Graham, Anne M.
KeywordType II diabetes
Fasting plasma glucose
The University of Bradford theses are licenced under a Creative Commons Licence.
InstitutionUniversity of Bradford
DepartmentSchool of Pharmacy & Medical Sciences
MetadataShow full item record
AbstractAim/Objectives: There were two aims; improving type II diabetes glycaemic control; and enhancing the role of community pharmacists by engaging them in type II diabetes medicine management. Methods: This quantitative study collected data from both community pharmacists and patients. In a premises survey, 426 self-administered questionnaires were distributed to community pharmacies. In a knowledge survey, 125 questionnaires were distributed to community pharmacists. In a clinical trial, 40 community pharmacies were randomly assigned to be control (18) and intervention (22) premises. Each pharmacy recruited 4 or 5 patients with type II diabetes. 225 patients were recruited and assigned to receive usual pharmacist care (n=100) or a pre-defined pharmacist intervention (n=125). Results: Community pharmacists had good knowledge of diabetes with average scores 21/29 (±3.18). The differences between control and intervention groups in patients' HbA1c and FPG changes were not significant. In the intervention group patients' diabetes knowledge was significantly improved (p=0.031). In the intervention group HbA1c and FPG improved significantly and in the control group FPG improved significantly and HbA1c did not. Patients' self-reported self-management activities improved significantly around blood glucose measurements (p<0.001) and physical exercising (p=0.001). Attitudes around the value of tight control of diabetes improved (p<0.001). Conclusion: The findings suggest that community pharmacists in Libya may have the ability to improve type II diabetes care. The primary outcomes were not improved in intervention versus control. The before/after analysis showed significant improvement in primary outcomes in the intervention group and also in one of the primary outcomes in the control group. Patients' self-reported self-care activities and attitudes improved significantly in the intervention group.
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The responses of lymphocytes from Asian and Caucasian diabetic patients and non-diabetics to hydrogen peroxide and sodium nitrite in the Comet assay.Anderson, Diana; Fontana, V.; Kelly, C.; Wyatt, N.P.; Merlo, D.F. (2006)Numerous factors may influence the incidence of diabetes in the population. The production of reactive oxygen species (ROS) is elevated in diabetes patients. Based on the reported involvement of reactive species and nitrate/nitrite in diabetes, this present study has examined in the alkaline Comet assay, the effect of different levels of NaNO2 in the presence of the oxygen radical generating agent, hydrogen peroxide (H2O2). Peripheral lymphocytes from diabetic and non-diabetic Caucasians and Asians of both sexes were studied in vitro. Endogenous factors (e.g., sex, age, body mass index-BMI) and exogenous factors (lifestyle factors e.g., smoking and drinking habits, diet) were taken into account. A preliminary study in two individuals showed that DNA damage remained constant over a wide dose range of NaNO2 (1-75 mM), but when H2O2 was added at a constant concentration of 50 ¿M per dose of NaNO2, there was an increase in DNA damage corresponding with the varying levels of NaNO2 investigated. This was also seen with the 44 individuals (non-diabetic, n = 24; type 1 diabetic, n = 11; type 2 diabetic, n = 9) investigated. NaNO2 was capable of inducing a significant level of DNA damage in lymphocytes (p<0.001), but only with the addition of H2O2. When levels of DNA damage were analysed in terms of the different variables there were few significant differences in damage between diabetic and non-diabetic subjects, or other sub-population groups, and no statistically significant differences in susceptibility were observed between subject covariates using regression techniques.
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