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  <front>
    <article-meta>
      <title-group>
        <article-title>Whether the use of a multidisciplinary approach may increase the adherence and effectiveness of treating patients with type 1 diabetes and type 2 diabetes?</article-title>
      </title-group>
      <contrib-group content-type="author">
        <contrib id="person-e15e8d1fe3b5a812ff00cebeee19f2df" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Kohut</surname>
            <given-names>Anna</given-names>
          </name>
          <email>kogutanna96@gmail.com</email>
          <xref ref-type="aff" rid="aff-2" />
        </contrib>
        <contrib id="person-763090a1b76a4d9ec531d286364ee9fa" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Frankova</surname>
            <given-names>Iryna</given-names>
          </name>
          <email>iryna.frankova@gmail.com</email>
          <xref ref-type="aff" rid="aff-2" />
        </contrib>
        <contrib id="person-82628415215475c62324d2719110b944" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Potapov</surname>
            <given-names>Oleksij</given-names>
          </name>
          <email>potapov.md@gmail.com</email>
          <xref ref-type="aff" rid="aff-3" />
          <xref ref-type="aff" rid="aff-1" />
        </contrib>
        <contrib id="person-f086f2b4c3f2f0727cb56105b5aa843c" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Bobryk</surname>
            <given-names>Maryna</given-names>
          </name>
          <email>100mib@rambler.ru</email>
          <xref ref-type="aff" rid="aff-4" />
          <xref ref-type="aff" rid="aff-2" />
        </contrib>
        <contrib id="person-0aa17e40315bf8f4c1c357e0832e5c6d" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Komisarenko</surname>
            <given-names>Julia</given-names>
          </name>
          <email>nmuendocrinology@gmail.com</email>
          <xref ref-type="aff" rid="aff-5" />
          <xref ref-type="aff" rid="aff-2" />
        </contrib>
        <contrib id="person-dee858aef8031be3da8af5cd3c9fec7a" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Chaban</surname>
            <given-names>Oleh</given-names>
          </name>
          <email>ocs@ukr.net</email>
          <xref ref-type="aff" rid="aff-6" />
          <xref ref-type="aff" rid="aff-2" />
        </contrib>
      </contrib-group>
      <aff id="aff-1">
        <institution content-type="orgname">SSI "CIMT of the NAS of Ukraine"</institution>
        <city>Kyiv</city>
        <country>Ukraine</country>
      </aff>
      <aff id="aff-2">
        <institution content-type="orgname">Bogomolets National Medical University</institution>
        <city>Kyiv</city>
        <country>Ukraine</country>
      </aff>
      <pub-date date-type="pub" iso-8601-date="2019-05-14">
        <day>14</day>
        <month>05</month>
        <year>2019</year>
      </pub-date>
      <volume>4</volume>
      <issue>1</issue>
      <issue-title>Psychosomatic Medicine and General Practice</issue-title>
      <elocation-id>e0401184</elocation-id>
      <history>
        <date date-type="received" iso-8601-date="2019-04-15">
          <day>15</day>
          <month>04</month>
          <year>2019</year>
        </date>
      </history>
      <abstract />
      <kwd-group xml:lang="">
        <kwd content-type="">Diabetes</kwd>
        <kwd content-type="">Psychosocial factors</kwd>
        <kwd content-type="">Psychological status</kwd>
        <kwd content-type="">Level of compliance</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body id="body">
    <sec id="sec-1">
      <title>Background</title>
      <p id="_paragraph-7">Diabetes mellitus (DM) type 1 (DM1) and type 2 (DM2) are complex systematic diseases that have required high-quality medical and social care. According to increase in the prevalence and incidence of these diseases among the population, there is a need for improving the process and quality of treatment. Glycemic control significantly depends on patients ' compliance with treatment and lifestyle. Therefore, it could be stated that the reason for their non-effective therapy – low level of commitment to treatment, which directly depends on psychological status and quality of life<xref id="xref-6636a7413ef17a38b0287cd8cb33b522" ref-type="bibr" rid="journal-article-ref-1644d6b1a1ef0cab1d11eec9b6197f3d journal-article-ref-b74fc2318af21144869d1187fa4a2368 journal-article-ref-28e79ed6f5d94e7953953643beb96995 journal-article-ref-4c525d0423e6f6b8c1cfc17b6f81c640 journal-article-ref-c22cb37e4c10575995c2b8e658ed4616">[1-5]</xref>.</p>
    </sec>
    <sec id="sec-2">
      <title>The aim of the study</title>
      <p id="_paragraph-8">The improvement of the treatment efficiency for patients with DM1 and DM2 in the process of researching the influence of psychosocial factors on their adherence to treatment.</p>
    </sec>
    <sec id="sec-3">
      <title>Method</title>
      <p id="_paragraph-9">Study population (n=60) consists of patients with DM type 1, 2 and newly diagnosed DM type 1, 2. Comparable groups consists of two research groups of patients with DM1 (n=16) and DM2 (n=33). Comparable groups (CG) of DM1 and DM2 were equivalent to age, demographic data, body mass index, level of glucose &amp; HbA1c results. The study data have been collected with the Patient Information Form (demographic data), including: Medication Compliance Scale (MCS), Chaban Quality of Life Scale (CQLS), Holmes and Rahe Stress Scale (HRSS), Dysfunctional attitudes Scale (DAS), The Depression, Anxiety and Stress Scale (DASS-21) and Toronto Alexithymia Scale (TAS-20). Glycemic control was based on glycated haemoglobin (HbA1c) laboratory results. The statistics analysis has been performed using Pearson's correlation and descriptive statistics with MS Excel and SPSS Statistics 22.0.</p>
    </sec>
    <sec id="sec-4">
      <title>Results</title>
      <p id="_paragraph-10">During the study there was found statistically significant difference of the results, according to MCS: between groups of patients with high (HC), middle (MC) and low level of compliance (LC). Patients with HC had higher quality of life level according to CQLS (r=0,37) by the results on level (p=0,004) and low rates of the DAS (r=-0,28), TAS-20 (r=-0,29), DASS-21(stress (r=-0,52), anxiety (r=-0,42) and depression (r=-0,55)) and HRSS (r=-0,5) results on general level (p=0,0001). The average values according to MCS results for CG – DM1 (M=19) and DM2 (M=18) present MC in patients at the same level. The average values by HbA1c results for CG – DM1 (M=10) and DM2 (M=10) have identical indicators. Based on the results of research – no statistically significant difference has been found between DM1 and DM2 in CG.</p>
    </sec>
    <sec id="sec-5">
      <title>Conclusions</title>
      <p id="_paragraph-11">Indicators of the psychological status of DM patients that have been determined by the results of psychometric scales, such as: the level of stress resistance and social adaptation, quality of life, cognitive distortions, alexithymia, depression, anxiety and stress - as probable psychosocial factors affecting the adherence to the treatment of patients with diabetes as 1 type and type 2, regardless of the diagnosis. Patients with LC have higher risk of ineffective treatment as a result and require qualified assistance from the specialists in mental health care and endocrinology to insure multidisciplinary approach to treatment of the patients with DM1 and DM2.</p>
    </sec>
  </body>
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