User experience and perceived usability of nurse-led telemonitoring among women with gestational diabetes in Dhulikhel, Nepal.

Objective: To assess the usability and acceptability of nurse-led telemonitoring in managing gestational diabetes among Nepalese women.

Methods: We conducted a convergent mixed-method study among 91 pregnant women diagnosed with gestational diabetes at Dhulikhel Hospital, Nepal. Participants received glucometers and blood pressure monitors, along with training and instructions to measure and record their blood pressure and glucose levels at home once a week.

Association of gestational weight gain rate with infant birth weight and cesarean delivery: A prospective cohort study in Nepal.

Gestational weight gain (GWG) is linked to pregnancy outcomes, such as birth weight and delivery mode, though research in low-income countries like Nepal is limited. We examined the association of GWG rate with infant birth weight and cesarean delivery in a prospective cohort of 191 pregnant women in Nepal, using data collected from August 2018 to August 2019 at a peri-urban hospital in Dhulikhel. Participants included women with singleton, full-term live births, with GWG rate calculated from weight gain between the second and late pregnancy stages, divided by the weeks in between.

Development and Testing of a Mobile App for Management of Gestational Diabetes in Nepal: Protocol for a User-Centered Design Study and Exploratory Randomized Controlled Trial.

Background: The prevalence of gestational diabetes mellitus (GDM) is increasing, particularly in low- and middle-income countries (LMICs) like Nepal. GDM self-management, including intensive dietary and lifestyle modifications and blood glucose monitoring, is critical to maintain glycemic control and prevent adverse outcomes. However, in resource-limited settings, several barriers hinder optimal self-management.

A service evaluation of weight management for glycaemic control and remission of type 2 diabetes using traditional food in Nepal (Ho-DIRECT NEPAL): a single-arm trial.

Background: Remission of early type 2 diabetes (T2D) is possible; however, diet programmes proven effective are unaffordable in many southeast Asian populations where T2D is more frequent and more aggressive at lower body weight and younger age. We evaluate an entirely food-based service.

Methods: This study employed a single-arm intervention and follow-up design for intervention evaluation in existing hospital people with T2D of under 5 years known duration.

Lifestyle Intervention in Reducing Insulin Resistance and Preventing type 2 Diabetes in Asia Pacific Region: A Systematic Review and Meta-Analysis.

Purpose Of Review: To update the evidence of lifestyle interventions for the prevention of type 2 diabetes mellites (T2DM) in adults, particularly in the Asia Pacific region. The key questions to ask are: 1) How effective are lifestyle interventions in preventing T2DM among at-risk adults in the Asia Pacific Region? 2)What are the key characteristics of the implementation of lifestyle interventions for diabetes prevention?

Recent Findings: Lifestyle interventions for the prevention of T2DM have been suggested to be effective. There is evidence of ethnic differences in some glycaemic and anthropometric outcomes.

Effectiveness of a group-based Diabetes Prevention Education Program (DiPEP) in a population with pre-diabetes: a cluster randomised controlled trial in Nepal.

Background: Although several lifestyle intervention studies have been conducted in low/middle-income countries, there were no such studies in Nepal. Therefore, a group-based culturally tailored Diabetes Prevention Education Program (DiPEP) was conducted recently. The study aimed to evaluate the effect of DiPEP in glycated haemoglobin (HbA1c), weight, waist circumference, physical activity and diet among population with pre-diabetes.

Designing and Developing a Mobile App for Management and Treatment of Gestational Diabetes in Nepal: User-Centered Design Study.

Background: Mobile apps can aid with the management of gestational diabetes mellitus (GDM) by providing patient education, reinforcing regular blood glucose monitoring and diet/lifestyle modification, and facilitating clinical and social support.

Objective: This study aimed to describe our process of designing and developing a culturally tailored app, Garbhakalin Diabetes athawa Madhumeha-Dhulikhel Hospital (GDM-DH), to support GDM management among Nepalese patients by applying a user-centered design approach.

Methods: A multidisciplinary team of experts, as well as health care providers and patients in Dhulikhel Hospital (Dhulikhel, Nepal), contributed to the development of the GDM-DH app.

Community-based lifestyle intervention for diabetes (Co-LID study) management rural Nepal: study protocol for a clustered randomized controlled trial.

Background: Type 2 diabetes mellitus (T2DM) has increased globally; with a disproportionate burden in South and Southeast Asian countries, including Nepal. There is an urgent need for clinically and cost-effective culturally adapted T2DM management programs. In this study, we aim to assess the effectiveness of community based culturally appropriate lifestyle intervention in improving the management and care of people with T2DM.

Digital Health Solutions for Community-Based Control of Diabetes During COVID-19 Pandemic: A Scoping Review of Implementation Outcomes.

Background: The COVID-19 pandemic has added to the pre-existing challenges of diabetes management in many countries. It has accelerated the wider use of digital health solutions which have tremendous potential to improve health outcomes for people with diabetes. However, little is known about the attributes and the implementation of these solutions.

How Did People with Prediabetes Who Attended the Diabetes Prevention Education Program (DiPEP) Experience Making Lifestyle Changes? A Qualitative Study in Nepal.

Diabetes can be prevented through lifestyle modification in the prediabetic phase. A group-based lifestyle intervention called 'Diabetes Prevention Education Program' (DiPEP) was tested recently in Nepal. The present study aimed to explore experiences of making lifestyle changes among people with prediabetes participating in the DiPEP.

Reliability and validity of a Global Physical Activity Questionnaire adapted for use among pregnant women in Nepal.

Background: Physical activity (PA) plays an important role in optimizing health outcomes throughout pregnancy. In many low-income countries, including Nepal, data on the associations between PA and pregnancy outcomes are scarce, likely due to the lack of validated questionnaires for assessing PA in this population. Here we aimed to evaluate the reliability and validity of an adapted version of Global Physical Activity Questionnaire (GPAQ) among a sample of pregnant women in Nepal.

A cluster randomized controlled trial of an electronic decision-support system to enhance antenatal care services in pregnancy at primary healthcare level in Telangana, India: trial protocol.

Background: India contributes 15% of the total global maternal mortality burden. An increasing proportion of these deaths are due to Pregnancy Induced Hypertension (PIH), Gestational Diabetes Mellitus (GDM), and anaemia. This study aims to evaluate the effectiveness of a tablet-based electronic decision-support system (EDSS) to enhance routine antenatal care (ANC) and improve the screening and management of PIH, GDM, and anaemia in pregnancy in primary healthcare facilities of Telangana, India.

Effect of a social media-based health education program on postnatal care (PNC) knowledge among pregnant women using smartphones in Dhulikhel hospital: A randomized controlled trial.

Introduction: Postnatal care services helps in detecting and subsequently managing life threatening complications. With the ubiquitous use of the mobile phone in Nepal, social media based postpartum education has the potential to increase PNC knowledge among pregnant women. This study aimed to assess the effect of social media-based health education program on PNC knowledge among pregnant women attending Dhulikhel hospital, Nepal.

Prevalence of prediabetes and associated factors of prediabetic stages: a cross-sectional study among adults in Nepal.

Objectives: To estimate the prevalence of prediabetes and to assess the association of prediabetic stages with sociodemographic, lifestyle and clinical factors DESIGN: Cross-sectional study at the screening and inclusion stage of a Diabetes Prevention Education Program (DiPEP) trial SETTING: The study was conducted in two urban communities in Nepal (October 2019-March 2020).

Participants: A total of 6222 residents of two study sites, aged 18-64 years and without a history of diabetes, were eligible for prediabetes screening. Exclusion criteria were pregnancy, history of diabetes and critical illness.

Association between 1 trimester diet quality & gestational weight gain rate among pregnant women in Dhulikhel, Nepal.

Background: Despite promising data from high-income countries, the impact of diet quality on gestational weight gain (GWG) has not been investigated in the context of many low-income countries including Nepal.

Methods: We prospectively examined the association between 1 trimester diet quality and GWG rate among a cohort of singleton pregnant women (n = 101; age 25.9 ± 4.

Stakeholder engagement in a hypertension and diabetes prevention research program: Description and lessons learned.

Background: Stakeholder engagement is important from the management point of view to capture knowledge, increase ownership, reduce conflict, encourage partnership, as well as to develop an ethical perspective that facilitates inclusive decision making and promotes equity. However, there is dearth of literature in the process of stakeholder engagement. The purpose of this paper is to describe the process of increasing stakeholder engagement and highlight the lessons learnt on stakeholder engagement while designing, implementing, and monitoring a study on diabetes and hypertension prevention in workplace settings in Nepal.

Reproducibility and Relative Validity of a Dietary Screener Adapted for Use among Pregnant Women in Dhulikhel, Nepal.

Objectives: Here we examined the reproducibility and validity of a dietary screener which was translated and adapted to assess diet quality among pregnant Nepalese women.

Methods: A pilot cohort of singleton pregnant women (N = 101; age 25.9 ± 4.

Antimicrobial Resistance in Isolated from Chicken Cecum Samples and Factors Contributing to Antimicrobial Resistance in Nepal.

Microorganisms with antimicrobial resistance (AMR) are prevalent among humans and animals, and also found in the environment. Though organisms with AMR can spread to humans via food from animal sources, the burden of AMR in food-producing animals remains largely unknown. Thus, we assessed the resistance pattern among isolated from chicken cecum samples and explored issues contributing to AMR in animals in the Dhulikhel Municipality of Nepal.

Strengthening urban primary healthcare service delivery using electronic health technologies: A qualitative study in urban Nepal.

Background: Nepal is a South Asian country with a high burden of non-communicable diseases. Electronic health technologies are a promising strategy to mitigate the rising burden of non-communicable diseases by strengthening primary healthcare center service delivery. However, electronic health implementation in Nepal is limited.

The Resistance Patterns in Isolates among Apparently Healthy Adults and Local Drivers of Antimicrobial Resistance: A Mixed-Methods Study in a Suburban Area of Nepal.

Evidence-based decision-making to combat antimicrobial resistance (AMR) mandates a well-built community-based surveillance system for assessing resistance patterns among commensals and pathogenic organisms. As there is no such surveillance system in Nepal, we attempted to describe the antimicrobial resistance pattern in isolated from the fecal samples of apparently healthy individuals in Dhulikhel municipality and also explored the local drivers of AMR. We used a mixed-method design with a cross-sectional quantitative component and a descriptive qualitative component, with focus group discussion and key informant interviews as the data collection method.

Consumer acceptance and preference for brown rice-A mixed-method qualitative study from Nepal.

Background: Brown rice consumption reduces the risk of diabetes. The prevalence of diabetes is increasing in Nepal; however, dietary preference remains for white rice. This study aimed to understand the perception, enablers, barriers, and facilitators of acceptance brown rice at a worksite cafeteria.