Effect of Lifestyle Modification Intervention on Diabetes Mellitus Treatment Outcomes in Tuberculosis Patients with Diabetes Mellitus in Southwest Nigeria
Abstract:
There
is an observed poor treatment outcome of Diabetes mellitus (DM) in patients with
Tuberculosis and Diabetes (TBDM) comorbidity due to interference of drugs used in
the treatment of Tuberculosis (TB) with first- line drugs used in the treatment
of DM. Insulin does not interact with TB drugs, but it is not accessible and affordable
to low–resource communities due to high cost. Hence a lifestyle-based intervention,
which this study evaluated to determine its effect on Diabetes control in these
individuals. It is a quasi-experimental intervention with two groups of 25 participants
each as experimental and control cohorts, enrolled from Tuberculosis Healthcare
centers in Lagos and Oyo states. The questionnaires were administered after the baseline Glycated hemoglobin (HBA1c) has
been measured, repeated after 12 weeks, and analyzed with SPSS software.
In the control cohort, the difference in the means of HBA1c was statistically significant
at 95%CI: 1.1(0.2 – 2.1; p<0.05), indicating a worsening of blood glucose control.
The difference in the means of educational scores was not significant 95%CI: -0.04(-2.8
– 2.7; p<0.05), showing no uptake. In the intervention group, the difference
in the means of the HBA1c was statistically significant 95%CI: -2.4(-3.1 – 1.6:
p<0.05), indicating improvement in glucose control. The difference in the means
of the educational and behavioral score was significant statistically 95%CI: 40.6(37.7
– 43.6; p<0.05) indicating uptake of behavioral changes. The intervention with
educational and behavioral lifestyle modifications improved the blood glucose control
as an adjunct to the conventional treatment with drugs compared to the control group.
Keywords: Behavioral change, Lifestyle, Treatment, Tuberculosis-Diabetes comorbidity.
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