Document Type : Original Article
1 Research Scholar, KIIT School of Management, KIIT Deemed to be University, Bhubaneswar, India
2 Professor, School of Management, KIIT Deemed to be University, Bhubaneswar, India
3 Senior Professor, School of Management, KIIT Deemed to be University, Bhubaneswar, India
Comorbidity and mortality are high among people with type-2 diabetes. Globally, diabetes is a major health issue, with a growing number of patients at risk of complications. A change in lifestyle is leading to an increase in diabetes prevalence. International Diabetic Federations (IDF) reports rank diabetes fourth among leading causes of death. Young adults are more likely to develop type-2 diabetes in Asia, where prevalence is on the rise. During the data collection period, most of the responses opined that diabetes is the mother of all the health related diseases. Concerning the relevance of the topic, we tried to focus the gap areas which are identified during the literature review. They are health related, psychological, and economic challenges which are encountered by the diabetic patients among the investor community in India. To address this issue, we tried to decode these challenges in the study areas. For this purpose, 187 responses were collected over six months by adopting snow ball sampling. This includes urban, rural, and semi-urban areas of Odisha. 37 variables were initially identified but finally after core group discussion and pilot study, the same being restricted to 30 only. This includes 13 for the health related sub variables, 11 for psychological variables, and rest were economic variables. For data analysis, perception score method and rank method used. The findings of the study are in case of health related challenges, sexual life, kidney issues, and foot ulcer are the major concern among the respondents. For the psychological challenges, feeling of more dependency on others, adverse comments of friends and relatives, depression, and anger are the main challenges. Similarly, for the economic challenges meeting medicine charges, consultation fees, and cost of healthy food are the major challenges.
Type 2 diabetes is a condition that happens because of a problem in the way the body regulates and uses sugar as a fuel. That sugar also is called glucose. This long-term condition results in too much sugar circulating in the blood. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous, and immune systems. In type 2 diabetes, there are primarily two problems. The pancreas does not produce enough insulin-a hormone that regulates the movement of sugar into the cells and cells respond poorly to insulin and take in less sugar. Type 2 diabetes used to be known as adult-onset diabetes, but both type 1 and type 2 diabetes can begin during childhood and adulthood. Type 2 is more common in older adults. However, the increase in the number of children with obesity has led to more cases of type 2 diabetes in younger people. There is no cure for type 2 diabetes. Losing weight, eating well, and exercising can help manage the disease. If diet and exercise are not enough to control blood sugar, diabetes medications or insulin therapy may be recommended.
India is often referred to as the ‘Diabetes Capital of the World’, as it accounts for 17% of the total number of diabetes patients in the world. There are currently close to 80 million people with diabetes in India and this number is expected to increase to 135 million by 2045 according to the publications of mayo clinic.
Worldwide, non-communicable diseases like type-2 Diabetes are the most important public health problem along with economic development, life standard improvement, lifestyle and dietary changes, and urbanization . Both developed and developing countries are experiencing an increase in diabetes prevalence. It is estimated that in 2025, there will be 300 million diabetic patients worldwide, from 110 million in 1994 . Like any chronic disease, diabetes can cause several personal, familial, social, and financial problems, as well as an increased mortality rate. There are many problems which negatively impact the lives of patients with diabetes, such as high blood sugar, dietary and exercise restrictions, frequent insulin injections, musculoskeletal complications, physical disabilities, sexual dysfunction, and vascular disorders . Likewise, there are many problems that affect the families, social and economic status of these patients, including job loss, frequent hospitalizations, higher medical care demands, indirect costs associated with early death, reduced social and familial interactions, and worsening lifestyles . Several services are provided by the diabetes clinic such as a secondary level: diagnosis, treatment, patient care, referral to a diabetes centre, follow-up feedback and appropriate action, assessment of complications in accordance with clinical guidelines, and collection and retention of patient information in medical records . The involved factors are not entirely understood, but numerous studies indicate that QoL is lower for diabetes patients than for healthy individuals. Among the variables that may interfere are the type of diabetes, insulin use, age, diabetes-related complications, social status, psychological factors, ethnicity, education level, knowledge of the disease, and the kind of assistance received from others .
Many diabetes-related morbidities and deaths can be attributed to diabetes complications. Since diabetes is a chronic disease, regular assessments are necessary. This tool is vital for predicting a patient's health status and determining the best course of action for disease management. The regular evaluation of patients as a routine clinical practice could potentially improve communication between health care providers and their patients, thereby identifying complications and assisting them in receiving long-term care . In addition to high rates of comorbidity and mortality, type 2 diabetes is a chronic illness . An increasing number of patients are at risk of complications related to diabetes, which is a serious health problem worldwide .
Diabetes prevalence is rising due to changes in lifestyle [10-12]. Young adults are also more likely to suffer from type 2 diabetes in Asia due to a rise in prevalence . There is a strong correlation between diabetes and the quality of life (QOL), which is viewed on a multifaceted basis, such as social, physical, and role functioning, stress, anxiety about tomorrow, and emotional well-being . Due to diabetes, most diabetics experience negative emotions such as frustration and loneliness . Age, gender, complications of diabetes, treatment, and duration of diabetes are several demographic and psychosocial factors that affect QOL . Several surveys have examined the psychosocial concept, which has shown that social support, self-care activities, diabetes awareness, sadness, worry, stress, and social support all affect quality of life [17, 18].
Ritalin intake for a long period may increase the number of atretic follicles and decrease corpora luteal, so subsequently results in reduction of growth of follicles and oocytes as well as inducing the atypical appearance of the cells in the luteinized cells . Retinitis pigmentosa (RP) might lead to various mental disorders, especially obsessive compulsive disorder . The results of the study showed were that an increase in the nurses knowledge can be reduce the number of medication errors. In conclusion, the number of medication errors among nurses should be mentioned . Family-based care training by telenursing could be effective in reducing the emotional reactions in mothers of children with bone marrow transplantation . Low self-efficacy can decrease cognitive and behavioural functioning, whereas increased self-efficacy leads to a change in treatment acceptance behaviour and subsequently, physical and mental health . Although the positive rate of tear RT-PCR rate is not noticeable as nasopharyngeal swabs yet, COVID-19 transmission through the eyes is biologically plausible .
The present study is very much relevant considering the issues faced by the diabetic patients. More specially the women and old age patients who are dependents on their family members for taking them to hospitals for medical checkup and at the same time, challenges of availing and availability of infrastructure led medial facilities and qualified doctors in the study areas in addition to various psychological, economical, and health related challenges.
To understand various health related challenges faced by type-2 diabetes among investors community in India.
To know various psychological challenges faced by type-2 diabetes among investors community in India.
To study various economic challenges faced by type-2 diabetes among investors community in India.
Materials and Methods
The present study will restrict to the diabetic patients in the study areas. The respondents include both male and female respondents of various age groups. This includes respondents of rural, urban, and sub-urban investor community in selected study areas of Odisha. The period of study was for six months. The study covers the urban areas of Bhubaneswar, Cuttack, Rourkela, Sambalpur, Puri, and Berhampur. In the rural areas, it includes outskirt of Bhubaneswar such as Bhola, Kantabada, Chhatabar, Jhankuli, Pandarabada, and similarly the sub-urban areas includes Digapahandi, Mahanga, Paradeep, Chhatrapur, and Polosora.
The present study calculated a sample size of 1:10 to 1:4 (Rummel, 1970). A minimum sample size of four times the number of items is recommended in the present study, while a maximum sample size of ten times the number of items is recommended. The study considered 30 attributes. According to Rummel (1970) and Schwab (1980), one should expect a minimum sample size of 120 and a maximum sample size of 300 in this study, 187 responses were included.
Health related challenges faced by type-2 diabetics include loss of memory, sleeping problem, kidney issues, heart problems, and sexual problems along with others. Psychological challenges include depression, personality disorder, fear of death, and felling of more dependency on others with other related issues. Similarly, the economic challenges include meeting medicine charges, consultation fees of doctor, cost of healthy food, etc.
Both primary and secondary data were used in this study. Research gaps were identified using secondary data. Sampling was conducted through snow ball. A literature review and seven core group discussions with 6 members each were conducted to identify the challenges of type-II diabetes, 37 attributes were considered initially. However, after the core group discussions and pilot study, 30 final variables retained. 64 respondents were considered for the pilot study purpose in the study area. This study used a Likert-type five-point scale method to compute data along with analysis of variance, with scores of four for Completely Aware (CA), three for Aware (A), two for Neutral (N), one for Not Aware (NA), and zero for Completely Not Aware (CNA). Data under 3 parameters are computed using perception weights for the various challenges faced by diabetic patients. The final conclusion done with the help of rank method.
In Table 1, the demographic profile and clinical characteristics have been considered. Demographic profile includes age in year, gender, marital status, education status, living status, occupation, monthly family income, place of origin, diet, and social habits. Similarly, the clinical characteristics include types of diabetes, family history, Body Mass Index (BMI), glycated hemoglobin %, treatment of diabetes microvascular complications and duration of diabetic of the respondents.
With reference to Table 2, answering to the questions related to health related challenges, in case of UMDP, loss of sexual life is an important challenge, followed by loss of sight, chest pain, kidney diseases, heart attack, foot ulcer etc. In case of UFDP, loss of sexual life, foot ulcer, feeling weak, chest pain, sleeping problem and fatigue problems are main challenges. In case of RMDP, feeling weak, kidney issues, fatigue problem, loss of weight and sleeping problems are the serious concern.
For the RFDP, loss of weight, fatigue problem, kidney issues and loss of sexual life are the main challenges. For SMDP, loss of sexual life, kidney issues, sleeping problems, chest pain and feeling weak are the major challenges and for the SFDP, loss of sexual life, problem during long walk, loss of memory, loss of sight, foot ulcer and chest pain are the main challenges.
In average ranking of all the groups taken together, sexual life, kidney issues and foot ulcer are the major concern among the respondents.
The Figure 2 is based on the data of health related challenges with reference to Table 2. Figure 1 explains the various dynamics of type-2 diabetes.
Based on Table 3, related to various psychological challenges, for UFDP, feeling of more dependency on others, loneliness, depression, fear of death, adverse comments of friends, and relatives for putting the extra weight are the major challenges. For the UMDP, adverse comments from friends and relatives, feeling of more dependency on others, putting weight due to lack of exercise, personality disorders are the main challenges. Similarly, for the RFDP. Anger, adverse comments, putting extra weight, depression, and feeling more dependency on others are the core challenges.
In case of RMDP, depression, personality disorder, feeling of more dependency on others, fear of death are main psychological challenges. For the SFDP, feeling of more dependency on others, adverse comments, feeling of social distance, depression are the main challenges. Accordingly, for the SMDP, feeling of more dependency on others, depression, loneliness, and uncertainty of future are the major challenges.
In the average rank, feeling of more dependency on others, adverse comments of friends and relatives, depression, and anger are the main challenges.
The Figure 3 is based on the data of health related challenges with reference to Table 3.
In Table 4, responding questions related to economic challenges, in case of SFDP meeting doctor consultation fees, cost of healthy food, meeting medicine charges along with others are the major challenges. For the SMDP, meeting medicine charges, doctor’s consultation fees, cost of healthy food along with others are core challenges. In case of RFDP, cost of health food, meeting consultation fees, and medicine expenses are the main challenges.
For RMDP, meeting medicine charges, cost of healthy foods and meeting consultation fees are the challenging area. Similarly, for the UMDP, meeting medicine charges, cost of healthy foods are the core challenges along with others. In case of UFDP, meeting occultation fees and cost of healthy food are the major challenges.
The Figure 4 is based on the data of health related challenges with reference to Table 4.
The purpose of the study was to know various challenges faced by the type-2 diabetes patients among investors community in India. The same being addressed with the help of three parameters considered for the study such as health related challenges, psychological challenges, and economic challenges. The findings based on the health related challenges indicates that most of the respondents having loss of sex life, kidney issues, foot ulcer, and chest pain. For the psychological challenges, it was observed that feeling more dependency on others, adverse comments from family and relatives, and depression are the contributing factors. Similarly, for the economic challenges viewpoint, meeting doctor’s consultation fees, meeting medicine charges, and cost of healthy food are the major findings. At the same time when any member of family suffers diabetes, it not only affects that person it directly or indirectly leads to lot of complications to entire family. Normally the impact of such diseases are such that it derails the life style of the patient along with other family members. During the survey, it was experienced that the difficulties that are being encountered by the family members along with the patients. There is no second thought that health related challenges are being faced by the diabetic patient, but the other associated challenges are also being experienced by the family members. In case of psychological and economic challenges, this is not only major challenges for the patients; this is equal challenge for other members of family especially in case of dependent family members of the diabetic patients. It is thus more important the diabetic patients should take all the necessary precautions to control this diabetes so that the various challenges can be addressed automatically. Especially various side effects can be reduced to a great extent. It is also important that the family members should behave cordially with the patients to overcome these challenges.
We are thankful to the all the participants in the study area who immensely contributed for the preparation of present article. We also equally thankful to all the health workers in the area who guided us for collecting the data.
No potential conflict of interest was reported by the authors.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
All authors contributed to data analysis, drafting, and revising of the paper and agreed to be responsible for all the aspects of this work.
Chandra Mohan Patnaik
HOW TO CITE THIS ARTICLE
Srutiva Mishra, B. Chandra Mohan Patnaik, Ipseeta Satpathy. Type-2 Diabetes among Investors Community in India. J. Med. Chem. Sci., 2023, 6(9) 2249-2258