Guidelines for the reduction of type 2 Diabetes Mellitus among older people living with HIV in Harare Urban District, Zimbabwe
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Authors
Mhlanga, Nongiwe Linette
Issue Date
2023-07
Type
Thesis
Language
en
Keywords
Alternative Title
Abstract
Background: The reduction of Type 2 Diabetes among older people living with HIV (older PLWH) is a pertinent issue due to increase in the number of PLWH who are ageing and developing age related chronic conditions like Type 2 Diabetes.
Aim: The purpose of the study was to develop guidelines for the reduction of Type 2 Diabetes among older PLWH in Harare.
Methods: The study used a qualitative approach supported by a scoping review of literature and an integrated literature review. The scoping review of literature identified risks of Type 2 Diabetes development. An exploratory descriptive design collected data from older PLWH and from nurses caring for older PLWH. Both samples were recruited purposively from five clinics in a low socio-economic area. Data analysis used Braun and Clark’ 6 steps. Findings from the two data sources were triangulated with an integrative literature review to develop guidelines. Ethical approval reference number for study is 14056739_CREC_CHS_2022.
Findings: The scoping review of literature mapped out five risks for Type 2 Diabetes development among older PLWH. These risks were long duration of HIV infection, use of older generation antiretroviral therapy with adverse effects of ART; lack of knowledge, a high body mass index and presence of hypertension. From the older PLWH it was concluded that physical activity included domestic chores, economic activities and exercise and healthy eating included consumption of whole grains, higher proportions of carbohydrates and lesser of protein, fruit and vegetables. Older PLWH had challenges of pain, fatigue, and depressive symptoms to implement self-care practices. The data from nurses concluded that screening included; risk assessment, signs and symptoms screening and random blood glucose testing. Health education was done in groups and individually with promotion of healthy eating and physical activity. These nursing interventions were determined by risks presented by older PLWH
Guidelines: Conditional guidelines included; use of metformin and screening PLWH from a younger age than the general population. Strong guidelines included; screening for excess risks, challenges and self-care practices, routine laboratory testing, involvement of a multidisciplinary team, providing individualised health education which promoted healthy lifestyle adjustments of eating and physical activity.