Browsing by Author "Butalia, Sonia"

Now showing 1 - 4 of 4
  • Thumbnail Image
    ItemOpen Access
    Clinical, sociodemographic, and environmental factors associated with hospitalizations for acute complications in adults with type 1 diabetes mellitus
    (2012) Butalia, Sonia; Rabi, Doreen M.
    Objective: To identify factors associated with hospitalizations for acute complications in adults with type 1 diabetes. Within this thesis, three discrete studies were conducted which assessed 1) clinical and sociodemographic factors; 2) driving distance to diabetes care sites; and, 3) seasonality. Methods: This thesis used clinical, administrative, and geographic data. Analysis included descriptive statistics, logistic regression models, and Geographic Information Systems (GIS) methodology. Results: The results showed: 1) Diabetic ketoacidosis (DKA) hospitalization was associated with shorter duration of diabetes, higher hemoglobin Ale, gastroparesis, and psychiatric disorders. Hypoglycemia hospitalization was associated with longer duration of diabetes and neuropathy; 2) Driving distance to diabetes care sites overall was not associated with hospitalizations; and, 3) DKA and hypoglycemia hospitalizations had seasonal variation. Conclusions: This thesis identified unique factors associated with hospitalizations for acute complications. This information could inform specific initiatives to improve the health and well being of adults with type 1 diabetes.
  • Thumbnail Image
    ItemOpen Access
    East African Immigrant Women with Gestational Diabetes Mellitus: A Mixed-methods Evaluation of the Care Experience in a Vulnerable Population
    (2016) Siad, Fartoon; Rabi, Doreen; Santana, Maria; Butalia, Sonia
    Background: Low rates of post-partum diabetes screening continues to impact the health of immigrant women diagnosed with gestational diabetes and high-risk for the development of future diabetes. The objectives of this study were to explore the diabetes resources available in Calgary and the care experiences of immigrant women. Methods: An online survey was distributed to six health clinics and community organizations involved in the provision of diabetes services to immigrant women. Ten East African women with gestational diabetes were identified and interviewed. Interviews were transcribed verbatim and thematically analyzed. Conclusion: The findings of this thesis suggest that current approaches to diabetes education and care in East African women with GDM lack cultural relevance to this high-risk community and do not emphasize the need for ongoing post-partum screening. Diabetes prevention using innovative community-level interventions such as patient navigators and care that engages and empowers women as partners in health are needed. Key words: Gestational diabetes, immigrant women, East Africa, health education, care experience, diabetes, post-partum screening.
  • Thumbnail Image
    ItemOpen Access
    Laboratory Use in Individuals with Early-Onset versus Usual-Onset of Diabetes: A Retrospective Cohort Study
    (2023-07) Sriskandarajah, Apishanthi; Butalia, Sonia; Metcalfe, Amy; Nerenberg, Kara
    Background: The incidence and prevalence of diabetes is increasing in younger individuals and these individuals are at an increased risk of complications. Laboratory testing is used to screen and monitor for complications in people with diabetes, and there is concern that this is not being achieved as per clinical guidelines. The objective of this thesis was to describe the frequency and results of guideline recommended laboratory tests in individuals with early-onset (<40 years of age) and usual-onset diabetes (≥40 years of age), and to explore clinical and sociodemographic factors related to guideline concordance of frequency of testing and results. Methods: This observational, retrospective cohort study used population-based administrative and clinical databases in Alberta from 2018 to 2019. We included adults with incident diabetes (age ≥18 years) and stratified by age of onset (<40 years versus ≥40 years). Individuals were followed for a total of 365 days for glycated hemoglobin (A1C), low-density lipoprotein cholesterol (LDL-C), estimated glomerular filtration rate (eGFR), and albumin to creatinine ratio (ACR) tests. Descriptive statistics were used to compare laboratory testing between early-onset and usual-onset groups. Multivariable logistic regression was used to assess factors related to guideline concordant testing frequency and above-target results. Results: Overall, the cohort included 23,643 individuals with incident diabetes (mean age 54.1 ± SD 15.4 years, 42.1% female). The early-onset group represented 18.9% of the cohort. A higher proportion of the early-onset group had lower frequency of testing for A1C, LDL-C, eGFR, and ACR tests and above-target test results for A1C and LDL-C compared to the usual-onset group. After adjustment of covariates (sex, socioeconomic status, rural residence, medication use), the early-onset group was more likely to have lower frequency of testing for A1C, LDL-C, and eGFR tests and above-target A1C and LDL-C levels compared to the usual-onset group. Sociodemographic and clinical factors were also associated with testing frequency and above-target test results. Conclusions: Despite a universal health care system, the early-onset group was not meeting clinical guidelines for testing frequency or targets. Future work is needed to inform tools and strategies to improve guideline recommended laboratory use in this group.
  • Thumbnail Image
    ItemOpen Access
    Transitional Care for Type 1 Diabetes: The Certified Diabetes Educator Perspective
    (2024-04-15) Rossiter, Brittany; dela Cruz, Aniela; Butalia, Sonia; Raffin Bouchal, Donna Shelley
    Adolescence is a time when significant growth and development occur. Undergoing typical developmental transitions may include experiences such as academic pursuits, applying to post-secondary education, and striving for increased independence. Adolescents living with type 1 diabetes (T1D) will experience typical developmental tasks and manage an invisible life-threatening chronic disease that requires constant input and thoughtful choices in food, insulin dosing, and more. The transition of care from pediatric to adult diabetes clinics occurs during this fragile period in an adolescent’s life (Allen & Gregory, 2009; de Beaufort et al., 2010). Much research has involved adolescents undergoing transition, their families, and some healthcare provider (HCP) input. However, there is a notable lack of insight from registered nurses (RNs) working as certified diabetes educators (CDEs). RN CDEs are often highly trusted members of the diabetes team and have direct and extensive contact with patients, their families, and other HCPs. Using classic grounded theory methodology, a qualitative study was undertaken to understand the perspective of registered nurses working as certified diabetes educators on the transition of adolescents from pediatric to adult diabetes care programs. Seven CDE nurses from Calgary, Alberta were interviewed. Data analysis was completed using the constant comparative process, coding, and memo-writing. The core category and theory of Adaptation, with supporting categories of Loss, Embrace the New, and Red Tape emerged through analysis. Additionally, nurse participants discussed practical options for improving transitional care for adolescents, their families and healthcare providers in Calgary, Alberta.