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- 저자 : Tamtomo Didik Gunawan (검색결과 2 건)
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Azmiardi Akhmad,Murti Bhisma,Febrinasari Ratih Puspita,Tamtomo Didik Gunawan 한국역학회 2021 Epidemiology and Health Vol.43 No.-
OBJECTIVES: Diabetes self-management education (DSME) programs are a strategy to maintain healthy behaviors. Nevertheless, limited evidence has been reported from systematic evaluations of the effects of DSME integrated with peer support on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes. METHODS: A systematic search was carried out in electronic databases, including PubMed, Cochrane Library, ProQuest, SpringerLink, Science Direct, Scopus, and Google Scholar, for English-language articles published from 2005 until 2020. The effect size was estimated as the standard mean difference (SMD). The Cochrane Collaboration’s tool was employed to assess the risk of bias. RESULTS: Twelve studies were included in this study. DSME integrated with peer support effectively reduced glycated hemoglobin A1c (HbA1c) levels, with a statistically significant effect (SMD, -0.41; 95% confidence interval [CI], -0.69 to -0.13; p < 0.001). Programs with a sample size < 100 (SMD, -0.45; 95% CI, -0.79 to -0.11; p = 0.009), duration of intervention ≤ 6 months (SMD, -0.52; 95% CI, -0.96 to -0.07; p= 0.020), baseline HbA1c < 8.5% (SMD, -0.42; 95% CI, -0.77 to -0.07; p= 0.020), delivery by group (SMD, -0.28; 95% CI, -0.51 to -0.06; p= 0.010), and high frequency of contact (SMD, -0.29; 95% CI, -0.48 to -0.10; p= 0.003) had statistically significant effects on reducing HbA1c levels in patients with type 2 diabetes. CONCLUSIONS: DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Programs with smaller participants groups, shorter interventions, weekly meetings, and closer group sessions improved glycemic control in patients with type 2 diabetes.
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Akhmad Azmiardi,Bhisma Murti,Ratih Puspita Febrinasari,Didik Gunawan Tamtomo 대한예방의학회 2022 예방의학회지 Vol.55 No.1
Objectives: Depression is a frequent complication of type 2 diabetes mellitus. This study aimed to investigate the relationship between low social support and risk for depression in people with type 2 diabetes through a meta-analysis. Methods: PubMed, ProQuest, SpringerLink, ScienceDirect, Scopus, the Cochrane Library, Embase, and Google Scholar were searched for English-language articles published up to 2021. Pooled adjusted odds ratios (aORs) were calculated using a random-effect model with 95% confidence intervals (CIs). Heterogeneity was evaluated by using the Cochrane Q test and I2 statistics. The risk of publication bias was estimated using a funnel plot, the Egger test, and the Begg test. The Joanna Briggs Institute Critical Appraisal Tools were used to assess the quality of evidence and the risk of bias. Results: Eleven studies were included in this meta-analysis, containing a total of 3151 people with type 2 diabetes mellitus. The pooled analysis showed that people with type 2 diabetes mellitus who had low social support had twice as high a risk of depression as those with high social support (aOR, 2.02; 95% CI, 1.51 to 2.70; p<0.001). A random-effect model was used because the heterogeneity was high (I2= 87%). Conclusions: Low social support was found to increase the risk of depression among people with type 2 diabetes mellitus. Further investigation into factors that may moderate this relationship is required.
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