Efficacy of empowerment education in self-management with Type 2 Diabetes Mellitus:A systematic review and meta-analysis

Objective:To evaluate the impact of empowerment education in self-management with Type 2 Diabetes Mellitus.Methods:A literature search was performed in PubMed,Web of Science,Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),WanFang Data,CQVIP and China Biology Medicine disc(CBMdisc)and for randomized controlled trials published before November 2018.RevMan5.3 software was used for metaanalysis.Results:A total of 11 articles were included,involving 1139 patients.The group of empowerment education included 574 participants,and the regular education groups 565 participants.Meta-analysis showed that the group of empowerment education has an advantage over the control group in the levels of self-efficacy[MD=17.55,95%CI(14.14,20.96),P<0.00001],self-management[SMD=0.85,95%CI(0.60,1.11),P<0.00001],as well as the effectiveness of short-term empowerment education(within 6 months)on reducing HbA1c(P<0.05);however failed to long-term empowerment education(beyond 12 months)(P=0.05).Conclusion:This meta-analysis indicates that empowerment education can be an acceptable and appropriated nursing intervention for type 2 diabetes mellitus patients.

Diabetes knowledge and self-care practices among people living with type 2 diabetes mellitus in a diabetes clinic in Southwestern Nigeria

Objective:The objective of this study is to assess the knowledge and self-care practices of people living with type 2 diabetes mellitus(T2DM).Materials and Methods:The study was conducted in a clinic in Southwestern Nigeria.It adopted a cross-sectional design.The sample consists of 107 people living with T2DM.Data were collected using Diabetes Knowledge Questionnaire and Revised Self-care Inventory Scale.Results:The mean diabetes knowledge of the participants was 16.2±3.0 and 70.1%had inadequate knowledge of T2DM.The mean diabetes self-care practice score among the participants was 49.9±4.9,and 89.7%reported poor diabetes self-care practice.There is no significant difference in the knowledge of diabetes between male(16.42±3.42)and female(16.12±2.8)participants(t=0.45;P=0.65),and no significant difference in self-care practice of male(49.23±4.51)and female(50.06±5.07)participants(t=0.75,P=0.46).In addition,there is no correlation between age and knowledge of diabetes(r=-0.18,P=0.07)and self-care practices(r=0.08,P=0.38)of participants.No significant relationship was found between knowledge of diabetes and diabetes selfcare practices(χ^(2)=1.605,P=0.448)Conclusion:Knowledge of diabetes and self-care practices of people living with T2DM in this study were poor.Effort should be directed at improving their diabetes knowledge and self-care practices.

Knowledge about Diabetes Mellitus and Self-Care Activities before and after an Educational Program: A Pilot Study

Background: Health education has proven to be an effective strategy to enable people with diabetes mellitus to manage this condition. However, few studies in Brazilian population samples have been conducted to evaluate the effects of educational programs on diabetes knowledge and self-care. Aim: To evaluate the knowledge about diabetes mellitus and the performance of self-care activities, before and after participation in an educational program. Methods: This is an intervention study, with a quantitative approach, in a single comparison group, for the analysis of “before and after” results related to an educational program focused on self-care and concurrent physical training. The study interventions consisted of 42 exercise sessions, as well as individual educational meetings, according to the needs of each participant and through nursing consultations, using educational material prepared from the literature. The sample was initially composed of 33 adults with diabetes mellitus, but 18 completed the study. For the assessment of knowledge and self-care activities, the revised Brazilian versions of the Diabetes Knowledge Scale and the Diabetes Self-Care Activity Questionnaire were used, respectively, in the two moments of the study, that is, prior to the first educational meeting and immediately before the first physical training session, and after the last educational meeting, which ran parallel to the 42nd physical training session, making a six-month interval between the two assessment moments for each participant. Results: The analysis of knowledge about diabetes showed significant improvement after the educational program and, as for self-care, there was clinical improvement in all dimensions, but only the dimension “general diet” obtained statistically significant improvement. Conclusion: The educational program has been shown to be beneficial for improving knowledge and self-care of the disease, which reiterates the need to maintain interventions of this nature for people with diabetes mellitus.

Predictors of diabetes self-management among type 2 diabetics in Indonesia:Application theory of the health promotion model

Objective:This study aimed to identify factors predicting diabetes self-management among adults with type 2 diabetes mellitus in Malang City,East Java,Indonesia.Methods:A cross-sectional design was used in this study.Participants were selected from five primary health centers in Malang City,East Java,Indonesia using the multistage sampling method.A total of 127 adults with type 2 diabetes mellitus were recruited.Data were collected by questionnaires which were the general diabetes knowledge,the Beliefs of Treatment Effectiveness,the Diabetes Distress Scale,the Self-efficacy for Diabetes Scale,the brief Chronic Illness Resources Survey,the Situational Questionnaire and the Summary of Diabetes Self-care Activities.A self-administered questionnaire was used to collect the data.Multiple linear regression with stepwise method was used toanalyze the data.Results:The scores of seven questionnaires(i.e,diabetes knowledge,perceived benefit of diabetes self-management,diabetes distress,perceived self-efficacy,social support,situational influence,and diabetes self-management)were 13.75±3.59,34.9±4.89,3.03±0.86,3.60±0.53,27.79±5.56,3.27±0.58,3.81±1.08,respectively.The significant predictors of diabetes self-management were treatment,perceived self-efficacy,and situational influences.These variables explained 20.8%(adjusted R^(2)=0.208)of the variance in diabetes self-management among adults with type 2 diabetes mellitus in Malang City.Conclusion:Diabetes self-management among adults with type 2 diabetes mellitus could be improved by enhancing their perceived self-efficacy to achieve their self-management behavior,such as having a healthy diet,exercising regularly,actively monitoring blood glucose level,taking medication and foot care,and providing support to promote good situational influence.

Impact of motivational interviewing on the quality of life and its related factors in type 2 diabetes mellitus patients with poor long-term glycemic control

Purpose:The aim of this study was to evaluate the impact of motivational interviewing(MI)on the quality of life and its related factors in type 2 diabetes mellitus(T2DM)patients with poor long-term glycemic control.Design and methods:One hundred tenT2DMpatientswithpoor long-termglycemic control that were hospitalized in our institution were enrolled in this study and randomly assigned to receive eitherMI or routine diabetes education intervention.Patients'body mass index values,Homeostatic Model Assessment-Insulin Resistance(HOMA-IR)scores,and levels of glycated hemoglobin(HbA1C),triglycerides,high-and low-density lipoproteincholesterols,Summary of Diabetes Self-management Activities and Diabetes Specific Quality of Life assessments were recorded before and six months after intervention.Results:Baseline scores for all measurements did not differ between patients in the control and MI groups.Although MI resulted in a significant reduction of HbA1c and serum lipid levels compared with the baseline,the effect was not significantly different from the control intervention.However,the improvement in HOMA-IR scores was significantly greater in the MI group compared with the control intervention(2.8±2.8 vs.5.7±4.7;p=0.000).Moreover,MI significantly elevated diabetes self-management activities ratings compared with the control intervention(13.2±3.4 vs.10.9±4.3;p=0.004).Conclusion:Compared to routine diabetes education,MI is a more effective approach for improving HOMA-IR and self-management of T2DM patients with poor long-term glycemic control.

Effect of motivational interviewing on selfmanagement in patients with type 2 diabetes mellitus: A meta-analysis

Objective:The objective of this meta-analysis was to evaluate the effect of motivational interviewing(MI)on self-management in patients with type 2 diabetes.Methods:Randomised controlled trials that assessed the effects of MI on self-management and HbA1c levels in patients with type 2 diabetes were systematically reviewed using multiple electronic databases.Weighted mean differences with 95%confidence intervals were calculated for continuous data.Results:Ten trials were included in this meta-analysis.The self-management ability of patients with type 2 diabetes who underwent MI was significantly better than that of patients in the control group(WMD,2.37;95%CI,1.77e2.98;p<0.00001).Subgroup analysis showed that short-term MI(
6 months)resulted in a significant decrease in the HbA1c level(p<0.05)but that this advantage was not present for relatively long-term MI(>6 months)(p>0.05).Conclusions:MI was associated with improved self-management abilities among patients with type 2 diabetes,and short-term MI(
6 months)effectively decreased the HbA1c level.The effect of long-term MI(>6 months)on the HbA1c level remains uncertain.Large-scale,higher-quality randomised controlled trials are needed to confirm the present findings.

Study on the Effect of Web-Based Real-Time Interactive Intervention Teaching Model on Self-Efficacy of Gestational Diabetes Mellitus Patients

Object: To explore the effect of web-based real-time interactive intervention teaching model on self-efficacy of Gestational Diabetes Mellitus (GDM) patients. Method: Based on the hospital’s antenatal check-up archives from June 2018 to January 2019, patients diagnosed with GDM in the second trimester were randomly divided into the control group (100 cases) and the experimental group (121 cases). Patients in the control group received routine care following the diabetes mellitus one-day outpatient guidance, while patients in the experimental group received social media real-time interactive teaching intervention based on routine care, and accepted a nursing intervention scheme based on knowledge-attitude-practice mode. The knowledge of GDM, self-efficacy and self-management behavior indicators were compared between the two groups. Results: After the intervention, the self-efficacy scores, the blood glucose monitoring times and the blood glucose compliance rates of the experimental group were significantly higher than those of the control group (P < 0.05). The post-intervention GDM knowledge scores of the experimental group were higher than those of the control group, and the difference was not statistically significant (P = 0.072). Conclusion: Web-based real-time interactive intervention teaching model can effectively improve the self-efficacy of GDM patients and promote the formation of healthy behaviors.

The moderating effect of social cognitive factors on self-management activities and HbA1c in Thai adults with type-2 diabetes

Background: Diabetes mellitus (DM) has become a serious chronic disease.Self-management strategies help persons with DM make choices which will develop skills needed to reach their goal of blood glucose control and allow them to be successful in reaching goals.Objective: To examine the impact of self-management activities on HbA1c for persons with DM and to examine the impact of social support,self-efficacy and Buddhist values as moderators on the relationship between the self-management activities and HbA1c.Method: This study is a cross-sectional design.The sample included 401 Thai adults diagnosed with type 2 diabetes,aged 20-65 years old who had at least one HbA1c test in the last three months were recruited.Participants completed four questionnaires to measure self-management activities,as well as self-efficacy,Buddhist values and social support as moderating factors on self-management activities and HbA1 c,Results: The self-management activities were negatively associated (β =-2.05,p ≤ 0.001) with HbA1c.The Social support,self-efficacy and Buddhist values had a significant interaction effect between selfmanagement activities and HbA1c (β =-0.97,p ≤ 0.05,β =-0.18,p ≤ 0.05 and β =-2.76,p ≤ 0.001).Conclusion: The diabetes self-management activities were more strongly associated with HbA1c under conditions of high social support,self-efficacy and health beliefs with Buddhist values.Future interventions for T2DM self-management programs should incorporate mechanisms to measure and support these factors.

Adherence to Treatment by Patients with Type 2 Diabetes Mellitus at Monze Mission Hospital, Monze, Zambia

Background: Diabetes mellitus (DM) is one of the most common non-communicable diseases and among the leading causes of disability, morbidity and mortality globally. The study assessed adherence to treatment by type 2 DM patients aged 20 years and above at Monze Mission Hospital in Monze district, Zambia. Research questions: 1) What is the level of adherence to treatment by type 2 DM patients receiving care from Monze Mission Hospital? 2) What factors influence adherence to treatment by type 2 DM patients? Methods: The study was conducted in 2017. It was a cross-sectional design. Simple random sampling method was used to select respondents and data was collected using a structured interview schedule. Data was entered and analyzed using the modified self-reported Morisky Medication Adherence Scale with six scores, modified self-care management questionnaire and IBM© Statistical Package for Social Sciences. Chi-Square was used to test associations between variables and binary logistic regression was used for multivariate analysis. The Morisky Medication Adherence scale was interpreted as follows: patients who scored between 4 - 6 points on knowledge had high knowledge while those who scored between 1 - 3 points had low knowledge about the disease. Results: The sample size of the study was 138 respondents. The study showed, only 44.2% of respondents had good adherence to treatment as they scored above 4 using the Morisky Medication Adherence Scale. Majority of the patients (55.6%) had knowledge about treatment despite 65.2% of respondents reported distance and financial challenges as hindrances to adherence. The study revealed a statistical association between adherence and knowledge of type 2 DM treatment. Conclusion: The study showed that poor adherence to treatment reduced as knowledge about DM increased. There is need to consider educational programs to strengthen adherence to dietary advice, regular exercise and follow up, to achieve normal glycemic levels.

Technology and diabetes self-management: An integrative review

Technology can be used to supplement healthcare provider diabetes care by providing both educational and motivational support. Education can be provided using technology allowing patients to learn new practices and routines related to diabetes management. Technology can support daily diabetes self-management activities including blood glucose monitoring, exercising, healthy eating, taking medication, monitoring for complications, and problem-solving. This article describes an integrative review conducted to evaluate the types of technology being used to facilitate diabetes self-management and the effect of that technology on self-management and diabetes outcomes for adults living with type 2 diabetes mellitus. A literature review was conducted by searching Medline, Pub Med, and Psych INFO databases using the search terms: diabetes self-management, technology, type 2 diabetes, smartphones, cell phones, and diabetes mellitus covering the years from 2008-2013. Articles relying on secondary data(editorials, systematic reviews) and articles describing study protocol only were excluded. Fourteen studies including qualitative, quasiexperimental, and randomized controlled trial designs were identified and included in the review. The review found that technological interventions had positive impacts on diabetes outcomes including improvements in hemoglobin A1 C levels, diabetes self-management behaviors, and diabetes self-efficacy. Results indicate that technological interventions can benefit people living with diabetes when used in conjunction with diabetes care delivered by healthcare providers.

Incidence and Determinants of Reported Hypoglycaemia among Patients with Type 2 Diabetes Mellitus in a Tertiary Health Institution in Nigeria

Introduction: Hypoglycaemia is a frequent and serious adverse effect of anti-diabetic therapy associated with both immediate and delayed adverse clinical outcomes. However, it continues to be a neglected complication with limited study of its burden, knowledge, determinants and preventive measures adopted by type 2 diabetics. Methods: Patients with type 2 diabetes who presented at Diabetes Clinic of a University teaching hospital and fulfilled selection criteria were recruited. The information obtained included sociodemographic, clinical details with hypoglycaemic symptoms and laboratory measurements. Results: There were 113 participants with a mean age of 60.94 ± 11.95 years. The majority of the patients had fair knowledge of hypoglycaemic symptoms and also knew what actions to take to ameliorate the symptoms when it occurs. The incidence of hypoglycaemia was 45.1% and most commonly occurred in the afternoon before lunch. The commonest symptoms reported by patients were shivering (76.1%), hunger (71.7%) sweatiness (71.5%) and weakness (69.9%). Almost one-fifth (19.6%) of those who reported hypoglycaemia had severe symptoms, of which 16.1% had hospital admission for its management. Use of insulin, duration of diabetes, age and possession of glucometers were some of the determinants of hypoglycaemic symptoms. Conclusions:?The burden of reported hypoglycaemia among type 2 diabetics is significant. Hence, diabetics at risk should always be asked about symptoms at each clinic visit. Early recognition of hypoglycaemia risks, self-monitoring of blood glucose (SMBG), appropriate education programs for both health care providers and patients with diabetes are the major ways to minimize risks of hypoglycaemia.

The knowledge, attitude, practice and predictors of complementary and alternative medicine use among type 2 diabetes mellitus patients in Indonesia

Objective: The prevalence of complementary and alternative medicine(CAM) usage among patients with type 2 diabetes mellitus(T2DM) in Indonesia is high. However, to date, little is known about why Indonesian T2DM patients choose CAM therapies, how their knowledge, attitude and practice(KAP) of CAM affects their choices, or how demographics correlate with patient choices. Therefore, this study aimed to investigate the KAP and predictors of CAM usage in T2DM patients in Indonesia.Methods: This was an observational, cross-sectional study. Patients were interviewed using a questionnaire. Chi-square tests or Fisher’s exact tests were used to compare demographic and clinical data, as well as KAP assessments, between T2DM patients who use and do not use CAM. Multivariate logistic regression analyses were used to investigate predictors of CAM usage.Results: A total of 628 T2DM patients were enrolled in the study. CAM therapies were used by 341 patients(54.3%). The most common therapies were herbs and spiritual healing, used by 100.0% and 68.3% of CAM-using patients, respectively. CAM therapies were frequently recommended by family members(91.5%), and CAM users had significantly more knowledge and more positive attitudes toward CAM therapies than nonusers. Among users, 66% said they would not follow their healthcare providers’ instructions to not use CAM therapies, and 69.5% said they would not disclose their plan to use CAM therapies with their healthcare provider. Neither demographic nor clinical characteristics were associated with CAM use. The factors that best predicted the use of CAM therapies were their availability and low cost(odds ratio [OR] = 4.59;95% confidence interval [CI]: 3.01–7.01), the belief that CAM therapies were safe(OR = 2.04;95% CI: 1.40–2.95), the belief that CAM therapies could help with diabetes control(OR = 1.75;95% CI: 1.15–2.66), and the belief that CAM therapies could help maintain physical health(OR = 1.68;95% CI: 1.13–2.49).Conclusion: CAM therapy users were more knowledgeable and had more positive attitudes toward CAM,but most of them chose not to disclose their CAM use to their healthcare providers. CAM use in Indonesia was associated with its accessibility, affordability, safety and effectivity, but not with any demographic or clinical characteristics. This study provided new evidence and insights for nurses and physicians in Indonesia that will help to design educational programs about the safety and efficacy of CAM therapies.

Determinants of Knowledge, Attitudes, and Practices among Young Adults Type 2 Diabetes Patients in Selected Tertiary Hospitals in Shandong Province, China

Objective: The purpose of this study is to understand the current situation of knowledge, attitude, and practice of self-management in young patients with type 2 diabetes mellitus (T2DM) and to explore the relationship between general conditions (personal, social, and environment, clinical factors) and their knowledge, attitude, and practices (KAP) of diabetes self-management, This aims to provide patients with high-quality nursing care management and services, as well as to provide relevant recommendations for effective self-management. Methods: This study is a descriptive correlational study that used the purposive sampling method to investigate 359 patients with T2DM aged 18-25 years in four designated tertiary hospitals in Shandong Province. Results: Knowledge of self-management was correlated with sex, age, education level, occupation and work situation, monthly household income, medical payment method, family and friend support, frequency of diabetes health education, and diabetes complications. The attitude subscale was correlated with sex, age, education level, work situation, and family and friend support. The practice subscale was associated with age, education level, work situation, family and friend support, frequency of diabetes health education, and HbA1c values. Conclusion: Young adults aged 18-25 with T2DM have positive attitudes towards diabetes self-management, but there are still deficiencies in knowledge acquisition and behavioral practice. The KAP of self-management of diabetes is influenced by personal factors such as sex, age, and education level, and socio-environmental factors such as family income and family or friends’ social support. Additionally, clinical factors such as complications and HbA1c values significantly impacted the patient’s disease self-management ability.

Mapping the knowledge of international Chinese medicines treatment on type 2 diabetes:A biblimetrical study

Objective:To uncover and identify the hot topic and frontier of Chinese medicines treatment of type 2 diabetes mellitus(T2DM).Methods:Web of Science TM was searched for published articles for Chinese medicines treatment of T2DM ranging from January 1st,2002 to July 6th,2016.Knowledge maps of the international Chinese medicines treatment of T2DM are visualized by using document cooccurrence analysis and word frequency analysis(Institution and Journal),co-citation clustering analysis(Co-reference),keyword co-occurrence clustering analysis with CiteSpac III,a tool of scientometrics.Results:Universidad Nacional Autonoma de Mexico is the institution with the highest number of published papers that had been cited in this field,while China has four institutions among the top 10.The journal of the highest frequency of co-cited journal was Diabetes Care,a core one in the field.Keywords co-occurrence network was composed of 185 nodes,541 lines,and divided into 10 clusters.Co-citation network of co-reference was composed of 407 nodes,1199 lines,and divided into 20 clusters.Using Chinese medicine to improve insulin resistance and Chinese medicine research on blood glucose control are the hot topics.The frontier contains two aspects:new drugs development and application of intestinal insulin treatment and development and use of traditional Chinese medicine antidiabetic plants.Conclusion:Institutions from China still plays a major role in TCM-focused T2DM studies.The effect of TCM herbs on insulin resistance is the hot topic of the domain.Developing new TCM herbal medicine that regulates incretin effect is the domain frontier.Research on the Chinese medicines treatment of T2DM needs more high-quality evidence to support,and its mechanism requires further exploration.

Knowledge, Attitude, and Practices Regarding Diabetic Eye Disease among General Population in Medina City, Saudi Arabia

Background: Diabetic eye disease is known as a group of eye problems that diabetic patients may develop as a complication of diabetes and can lead to blindness. They may include Diabetic retinopathy (DR), Cataracts, and Glaucoma. Objectives: This study aims to assess the knowledge, attitude, and practices (KAP) around diabetic eye disease in the general population including patients with DM and non-diabetic people in Medina City, Saudi Arabia. Methods: This is a cross-sectional study involving 385 participants via a self-administered online Questionnaire started in January 2023 in Medina, Saudi Arabia. Results: In total, 339 participants with ages ranged from 18 to more than 60 years with a mean age of 26.8 ± 12.6 years old completed the questionnaire. The majority were females (74.6%), singles (67.8%), and had a university level of education (54.6%). Most of the study participants were found to have poor knowledge levels (67%) in comparison to 33% who had an overall good knowledge of diabetic eye diseases. Knowledge level was found to be higher among old-aged participants and those with a family history of DM (P = 0.001, P = 0.049) respectively. Regarding participants’ attitudes and practices, the study showed good attitudes toward eye care practice for diabetics with half of the participants (50%) reporting self-awareness as a reason that made them undergo the first eye screening. Conclusion: Participants in the present study have poor knowledge and awareness level of diabetic eye disease. Furthermore, positive attitudes and perceptions have been revealed by the participants toward the practice of providing eye care for diabetics. .

Development and evaluation of the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes

Objectives:This study aims to develop the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes(DNSS-T2DM)to measure diabetes-specific support and patients’preference as well as evaluate the construct validity and reliability of the DNSS-T2DM.Methods:A cross-sectional study was conducted in Tongzhou District,Beijing,China from July to September 2015.A total of 474 participants who had been diagnosed as type 2 diabetes by physicians and completed the DNSS-T2DM were included.The original 11-item DNSS-T2DM contains five items on nondirective support(Items 1-5)and six items on directive support(Items 6-11).There were two parallel questions for each item with one to measure the preference for support(Preference part)and the other to measure the perception of support in reality(Reality part).The final DNSS-T2DM was determined based on the results of the exploratory factor analysis(EFA).The construct validity of the final DNSS-T2DM was evaluated by the confirmatory factor analysis(CFA).The reliability was evaluated by internal consistency with Cronbach’sαcoefficients.Results:A final 7-item DNSS-T2DM loaded on 2 factors with four items representing nondirective support and three items representing directive support was determined based on the EFA.The CFA indicated a satisfactory construct validity.The internal consistency of the 7-item DNSS-T2DM as well as the nondirective support items was satisfactory with Cronbach’sα≥7.00.70.Conclusions:Our study supported the validity and reliability of the 7-item DNSS-T2DM.Further studies on the application of the DNSS-T2DM in different settings and population are needed.

An Assessment of the Diabetic Knowledge, Attitude, and Practice of School Teachers in Riyadh, Kingdom of Saudi Arabia

Background: Teachers are the cornerstone of the next generation and they are considered an important source of health information for students about diabetes. The objective of this study is to assess the knowledge, attitude, and practice (KAP) of teachers about diabetes mellitus (DM) and to identify the associated factors. Methods: Cross-sectional study design included a stratified random sample of male and female teachers from public and private schools in Riyadh city. A self-administered online questionnaire was developed. The data collection was from October to November 2019. Results: The study included 633 teachers. Overall, 57.2% of the surveyed teachers were knowledgeable about DM. Teachers aged between 51 and 60 years (p = 0.005), males (p = 0.018), PhD holders (p = 0.011), teaching science (p = 0.021), having more than 20 years of teaching experience (p = 0.001), diabetics (p < 0.001), and having family history of diabetes (p = 0.007) had the highest level of knowledge. Overall, positive attitude towards DM was reported among 53.1% of the teachers. Those with teaching experience between 11 and 15 years (p = 0.024), diabetics (p = 0.029), and having a diabetic student (p = 0.012) had more positive attitude towards diabetes. Good diabetes-related practice was observed among 54.3% of the teachers. Older (p < 0.001), having more than 20 years of teaching experience (p < 0.001), non-Saudi (p = 0.011), diabetic teachers with longer duration of the disease (p < 0.001), having family history of DM (p = 0.028), and principals (p = 0.002) had the highest level of good diabetes-related practice. Conclusion: The KAP of teachers in public and private schools in Riyadh about DM was sufficient in many aspects. However, targeting new young teachers should be a priority to raise awareness.

Knowledge, Attitude and Practice on Common Diabetic Patients among Diabetic Complications at Egyptian Hospital in Mogadishu, Somalia

Diabetes is a chronic illness that occurs when the pancreas stops producing insulin or when the body cannot use the produced insulin. Insulin is a hormone produced by the pancreas that helps glucose from meals enters the body’s cells for energy. The overall goal is to assess diabetes patients’ knowledge, attitudes, and behaviors about prevalent diabetic complications. This research used a descriptive qualitative methodology to assess diabetes complication knowledge, attitude, and practice. Ninety-eight diabetic patients were visiting the Egyptian Hospital in Mogadishu for four weeks. The data was collected using questionnaires. Finally, SPSS 20 was utilized for analysis. The research was performed from May to July 2020 with a non-probability sample size of 98 diabetics. The bulk of responders were aged 40 - 60 (36.7%). Type 2 was the most common (47.96%). 44.9% of respondents had diabetes for more than ten years. 60.2% had regular checkups, and 54.1 percent had therapy. 52% of participants were on a diet. 63.3% of respondents do not exercise often. However, most responders know the common issues (75%). Less than half of those polled had problems (41.8%). 22% incidence of Diabetic ketoacidosis. 78.6% of respondents know variables that decrease diabetes complications, whereas 22.4% do not. 37.8% of respondents saw a doctor for diabetes problems, whereas 62.2% did not. Diabetic patients’ knowledge, attitude, and practice were satisfactory for fundamental illness entanglements and self-testing. These findings may also be due to patient notification and, therefore, long-term illness that leads them to get acquainted with things alone. However, the tendency for regular exercise was low, which may produce more specific consequences of illness. Conclusion: We find that DM patients’ KAP was adequate in terms of knowledge of diabetic complications. These results may explain the patients’ long-standing illness, which forces them to discover things independently. At the same time, just a handful of them were familiar with vasculopathy and cardiovascular disorders. However, the researchers discovered low level of attitudes and practice toward regular exercise and insufficient levels of attitudes and practice toward diet management and treatment adherence. In general, this degree of KAP is suboptimal and requires further assessment of KAP obstacles in Somalia.

Self-Care Activities among Patients with Type 2 Diabetes in Morocco: Prevalence and Determinants

Background: Self-care is an important, though often neglected, area of type 2 diabetes management in lower and middle income countries (LMICs). In Morocco, whilst the evolution of the disease is increasing rapidly, evidence documenting disease self-care patterns remains scarce. Objectives: To estimate the prevalence of self-care activities among patients with type 2 diabetes in Morocco, and to identify the factors associated with good self-care practices. Methods: We performed a secondary analysis of data of 406 patients aged 30 years old and over, diagnosed with type 2 diabetes mellitus for at least 6 months. Self-care activities were assessed using the Moroccan version of the Summary of diabetes self-care activities. Studied factors included socio-demographics, disease features and healthcare use. Unadjusted and adjusted odds ratios were calculated using logistic regression. Results: Mean age was 55.8 ± 11.6 years old. Females represented 68.7% of the respondents. Mean estimates of the frequency of self-care practices exceeded 3.5 days per week for diet, exercise and foot-care;of these, good dietary behavior was the most prevalent (63.6%). In multivariate analysis, females displayed better dietary behavior (OR = 1.81 [1.27 - 2.58]), and less frequent foot care (OR = 1.81 [1.27 - 2.58]) than males. Lower levels of exercise were associated with being female (0.42 [0.26 - 0.68]), and belonging to the higher income category (0.55 [0.34 - 0.88]). Residents in rural areas also reported better exercise practices (1.72 [1.07 - 2.78]). Conclusion: This study draws attention to self-care practices and their determinants in the Moroccan context. Such findings should help in the design, implementation, and evaluation of self-management interventions for people with type 2 diabetes.

The Knowledge, Attitudes and Practices of Diabetics on Physical Activity at the Marc Sankale Center of Dakar

Introduction: The objective of that study was to evaluate diabetics knowledge, attitudes and practices on physical activity. Patients and Methods: That study has concerned 200 diabetics at Marc Sankale antidiabetic Center of Abass Ndao Hospital in Dakar. Women represent 76% with a sex ratio M: F0.13. The average age is 54 years with extremes of 4 to 84 years. The housewives are 29% and among them 15% haven’t any professional activity. 45.07% of the population is illiterate. In our study, 63.13% of patients have low socio economic level. In our series, the majority of patients is type 2 diabetes (89.5%). The diabetes evolution time is about 8 years inferior to 7% in 84 patients. In our study obesity is noted in 17.20% of cases. The HTA is present in 56% of cases. 54% of the studied population presents a dyslipidemia. Physical activity is practiced in 81% of patients. In our study the doctor’ advice motivates the half of our patients to practice physical activity (62.26%). The lack of time (43.2%) and volution (8.1%), the useless character of physical activity (2.7%) and the patients’ health state 45.9% are the obstacles to the practice of physical activity. The average frequency of physical activity practiced by patients is about 4 times a week with extremes ranging from 1 to 7 stages a week. The average time of activity practiced by patients is 39.72% with extremes ranging from 10 to 150 mn. 87% of patients practice physical activity at least 3 times a week. The main risks noted from intense physical activity in diabetics are hypertension 39.0%, ortestic hypertension 3.0%. In the contrary 58.8% of patients ignore the answer. Conclusion: Our study demonstrates the ignorance of diabetics on physical activity. Therefore it would be necessary to reinforce the training mainly therapeutic education in the patients taken into account.